Claim total
$126.29
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-01-18
- Stop
- 2018-01-18
The parties
- Patient
- patient Senaida Carole Miller
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
18b101ed-6582-7193-934e-f5c82e0d6539