Claim total
$363.83
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2009-08-12
- Stop
- 2009-08-12
The parties
- Patient
- patient Cyndy Thora Hackett
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
3a6342ed-106b-b99c-be7d-491fa07bee20