Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-09-28
- Stop
- 2017-09-28
The parties
- Patient
- patient Reyna Carroll
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
12cb4f8d-eea3-ec6a-2e02-99713c808a9c