Claim total
$155.61
base $93.39 · payer covered $124.49
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-09-10
- Stop
- 2021-09-10
The parties
- Patient
- patient Cassi Latoya Hilpert
- Provider
- provider Morton Boyer
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
11c79940-311a-7715-b432-4fa16e0cc5e3