Claim total
$366.19
base $93.39 · payer covered $292.95
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-10-12
- Stop
- 2021-10-12
The parties
- Patient
- patient Carmen Gia Robel
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
0b18fec5-d601-b59b-1962-f21fb3792779