Claim total
$751.47
base $93.39 · payer covered $649.07
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-05-02
- Stop
- 2024-05-02
The parties
- Patient
- patient Marc Ricky Gleason
- Provider
- provider Donette Hilpert
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
3876a6d0-4d16-b874-6af7-36e46b2c2e22