Claim total
$744.00
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2014-09-07
- Stop
- 2014-09-07
The parties
- Patient
- patient Donovan Gustavo Olson
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Cigna Health
Record id
0b5d76d4-5c56-6b2a-60cb-833d2b3fe413