Claim total
$3,223.62
base $93.39 · payer covered $376.33
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-12-24
- Stop
- 2020-12-24
The parties
- Patient
- patient Jana Beulah Cruickshank
- Provider
- provider Jonas Pouros
- Care site
- care site NORTH MEMORIAL HEALTH CARE
Record id
18d76ed3-42d4-15d1-03d1-82cbdf37c2eb