Claim total
$751.47
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2023-09-13
- Stop
- 2023-09-13
The parties
- Patient
- patient Grant Earl Fay
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
1db3f28a-a567-c10e-acff-ecfb64f6eff9