Claim total
$10,124.19
base $93.39 · payer covered $4,212.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2025-12-17
- Stop
- 2025-12-17
The parties
- Patient
- patient Elenore Astrid Ryan
- Provider
- provider Yasmine Shanahan
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Aetna
Record id
2b192cee-fe62-521f-d5fe-f619a99b13c5