Claim total
$10,124.19
base $93.39 · payer covered $5,049.81
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-06-24
- Stop
- 2020-06-24
The parties
- Patient
- patient Domingo Jeff Prosacco
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
Record id
39eb5ea2-5667-6205-b252-bbc1eb13b4e9