Claim total
$4,267.36
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-11-21
- Stop
- 2022-11-21
The parties
- Patient
- patient Vance Archie Kirlin
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
0b490094-beb0-b779-aaf8-64033164a9cb