Claim total
$399.61
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-09-22
- Stop
- 2021-09-22
The parties
- Patient
- patient Tarah Delisa Feil
- Provider
- provider Yasmine Shanahan
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
335f5e30-54ea-97ea-1a2f-38df9596ed03