Claim total
$555.97
base $93.39 · payer covered $555.97
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2016-01-08
- Stop
- 2016-01-08
The parties
- Patient
- patient Norbert Mitch Rolfson
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Aetna
Record id
0e9a274f-7ba6-2bd1-9262-fb81cb7a3d21