Claim total
$5,696.90
base $93.39 · payer covered $4,276.94
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-11-10
- Stop
- 2017-11-10
The parties
- Patient
- patient Ione Yahaira Glover
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer UnitedHealthcare
Record id
21ffffe4-f03e-a436-be7a-66f52b555297