Claim total
$4,227.28
base $93.39 · payer covered $3,381.82
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2016-11-25
- Stop
- 2016-11-25
The parties
- Patient
- patient Cassi Latoya Hilpert
- Provider
- provider Darnell Reynolds
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
11c79940-311a-7715-1d42-450c9b4b88d0