Claim total
$2,601.09
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-12-20
- Stop
- 2021-12-20
The parties
- Patient
- patient Robert Lavern Schaefer
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Cigna Health
Record id
335b9834-6d45-11e5-1ae7-7991dba61eeb