Claim total
$126.29
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-05-10
- Stop
- 2017-05-10
The parties
- Patient
- patient Cristina Caridad Salcedo
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
031e24ca-9978-b353-6a0a-832e9568dfdb