Claim total
$255.29
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-11-21
- Stop
- 2019-11-21
The parties
- Patient
- patient Toni Jin Smitham
- Provider
- provider Stuart Bergnaum
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Aetna
Record id
34d094b9-9371-6558-6006-fb6c2f50cac1