Claim total
$9,257.78
base $93.39 · payer covered $2,767.40
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2014-09-06
- Stop
- 2014-09-06
The parties
- Patient
- patient Dawne Brett Parker
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Aetna
Record id
32cc0b83-f353-e71c-33a0-cd97cd496035