Claim total
$126.29
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2012-10-23
- Stop
- 2012-10-23
The parties
- Patient
- patient Eulah Avril Aufderhar
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer No insurance
Record id
02aef5a1-9ba3-229b-f704-ba2e5d6ad8a2