Claim total
$305.82
base $93.39 · payer covered $244.65
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2016-12-05
- Stop
- 2016-12-05
The parties
- Patient
- patient Erwin Eli Hackett
- Provider
- provider Darnell Reynolds
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
24f27ab5-b47f-0e8d-3cf1-5103c0fe8844