Claim total
$2,601.09
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-12-24
- Stop
- 2022-12-24
The parties
- Patient
- patient Gary Carolynn Bergstrom
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
286699ff-b159-7b1a-2b13-e6743679882d