Claim total
$548.24
base $93.39 · payer covered $498.24
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-06-23
- Stop
- 2018-06-23
The parties
- Patient
- patient Marc Ricky Gleason
- Provider
- provider Yasmine Shanahan
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
3876a6d0-4d16-b874-4489-88dd2a77b931