Claim total
$126.29
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2016-07-14
- Stop
- 2016-07-14
The parties
- Patient
- patient Verda Mariette Ruecker
- Provider
- provider Morton Boyer
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer UnitedHealthcare
Record id
26263485-8712-cf88-0818-fc8deeb8f8b2