Claim total
$224.29
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2016-11-10
- Stop
- 2016-11-10
The parties
- Patient
- patient Malvina Jodie Funk
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
3566cc77-5678-10db-2902-69457f3b245b