Claim total
$326.67
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-12-21
- Stop
- 2024-12-21
The parties
- Patient
- patient Nichol Clara Predovic
- Provider
- provider Tiffany Smitham
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
0130f9d2-4df9-4b02-6383-edf7b57bf748