Claim total
$93.39
base $93.39 · payer covered $56.03
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Viral sinusitis444814009
- Start
- 2013-12-29
- Stop
- 2013-12-29
The parties
- Patient
- patient Xuan Collier
- Provider
- provider Rebeca Lomeli
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
002d4429-df26-5797-2145-08fa5c43bb8f