Claim total
$304.74
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-10-12
- Stop
- 2024-10-12
The parties
- Patient
- patient Clemente Kelley Bernier
- Provider
- provider Clyde Beier
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
069c23ee-b44f-ad9c-1c82-84a0026ebbf1