Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-09-03
- Stop
- 2017-09-03
The parties
- Patient
- patient Jeffie Vivan Lowe
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer UnitedHealthcare
Record id
357b1f09-8ef7-8091-e53d-7973aa9f0b2f