Claim total
$160.74
base $93.39 · payer covered $105.97
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2026-03-13
- Stop
- 2026-03-13
The parties
- Patient
- patient Bruce Oscar Rath
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
38d7b5e6-2762-29d7-73ad-fc1d9c16416e