Claim total
$387.82
base $93.39 · payer covered $337.82
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 1959-10-13
- Stop
- 1959-10-13
The parties
- Patient
- patient Maurice Fletcher Purdy
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
359652b4-936c-ae33-e721-5d212114736f