Claim total
$5,192.08
base $93.39 · payer covered $3,115.25
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute infective cystitis307426000
- Start
- 2014-04-03
- Stop
- 2014-04-03
The parties
- Patient
- patient Xuan Collier
- Provider
- provider Walter Volkman
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
002d4429-df26-5797-57a5-a5f197f3af6d