Claim total
$751.47
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2026-07-11
- Stop
- 2026-07-11
The parties
- Patient
- patient Domenic Ivory Bartoletti
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
2caefad2-5d5c-2c45-0f97-e8d37213eab5