Claim total
$610.46
base $93.39 · payer covered $488.37
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-06-08
- Stop
- 2021-06-08
The parties
- Patient
- patient Carmen Gia Robel
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
0b18fec5-d601-b59b-116d-3a8e3c247c3f