Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2012-06-23
- Stop
- 2012-06-23
The parties
- Patient
- patient Shane Fredricka Sanford
- Provider
- provider Jo Stiedemann
- Payer
- payer Aetna
Record id
0cc8b4ab-e908-a6cb-f46c-51e0a901603b