Claim total
$355.98
base $93.39 · payer covered $355.98
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 1980-12-09
- Stop
- 1980-12-09
The parties
- Patient
- patient Raye Suzy Gusikowski
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
02c06e54-48b8-2b73-b9ff-987d7dffdb85