Claim total
$269.91
base $93.39 · payer covered $215.93
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2010-06-05
- Stop
- 2010-06-05
The parties
- Patient
- patient Roy Billie Ankunding
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
2cc69e6e-eaec-c9c0-b3fc-5677f59b01c8