Claim total
$6,558.44
base $93.39 · payer covered $1,010.72
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2016-02-04
- Stop
- 2016-02-04
The parties
- Patient
- patient Leo Ramon Wolf
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Aetna
Record id
0132d8d5-6e6e-d90f-89d4-8343a873b274