Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2025-10-11
- Stop
- 2025-10-11
The parties
- Patient
- patient Richie Michael Mante
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer No insurance
Record id
12bd5fca-647b-3667-1d1f-feb1bcdc01c6