Claim total
$751.14
base $93.39 · payer covered $492.59
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-12-23
- Stop
- 2018-12-23
The parties
- Patient
- patient Louie Petrina Ziemann
- Provider
- provider Darnell Reynolds
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
2db8ed08-2422-5c8b-6edc-f47e864c8f13