Claim total
$505.64
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2016-03-11
- Stop
- 2016-03-11
The parties
- Patient
- patient Ali Darron Greenfelder
- Provider
- provider Tiffany Smitham
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
08ba36d2-4051-3238-720b-5534091b7ced