Claim total
$751.47
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2023-09-12
- Stop
- 2023-09-12
The parties
- Patient
- patient Monroe Morris Marks
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer UnitedHealthcare
Record id
19485005-e439-ac2a-7e7c-ef07bcc94468