Claim total
$316.87
base $93.39 · payer covered $316.87
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-08-15
- Stop
- 2017-08-15
The parties
- Patient
- patient Elke Oda Crona
- Provider
- provider Charlie Tillman
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Humana
Record id
11487152-d64b-d12d-e69e-85fa3b9c8ccd