Claim total
$751.47
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-06-27
- Stop
- 2017-06-27
The parties
- Patient
- patient Cletus Erin Macejkovic
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Cigna Health
Record id
06b69cf7-c26b-5083-d924-8275f97e3614