Claim total
$2,601.09
base $93.39 · payer covered $1,560.65
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-05-17
- Stop
- 2024-05-17
The parties
- Patient
- patient Jesusa Altha Harris
- Provider
- provider Goldie O'Hara
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
075c319c-5d10-4b7a-7f81-e91b853c069a