Claim total
$751.47
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-04-01
- Stop
- 2017-04-01
The parties
- Patient
- patient Simonne Karol Waters
- Provider
- provider Lady Frami
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer No insurance
Record id
0bf434c4-3a7d-8f3d-5173-6cfdfc7dbb16