Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-03-07
- Stop
- 2022-03-07
The parties
- Patient
- patient Kizzy Blondell Hermann
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
0fa13c65-5aee-f679-e139-efb9d5d99ad9