Claim total
$4,569.81
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2025-06-05
- Stop
- 2025-06-05
The parties
- Patient
- patient Reatha Victor O'Conner
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Aetna
Record id
0521a0be-ba7b-b4e6-7e8e-4e8d2e84baee