Claim total
$12,614.31
base $93.39 · payer covered $4,025.06
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-10-03
- Stop
- 2024-10-03
The parties
- Patient
- patient Bradly Sebastian Stehr
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Aetna
Record id
16ca8200-6a76-b40e-6b83-ae4ef3a01ee7