Claim total
$686.83
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-01-01
- Stop
- 2024-01-01
The parties
- Patient
- patient Palma Roberts
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
0a378f33-73dc-7635-7824-2763a5d51692