Claim total
$10,124.19
base $93.39 · payer covered $3,445.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2010-08-16
- Stop
- 2010-08-16
The parties
- Patient
- patient Cyndy Thora Hackett
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
3a6342ed-106b-b99c-e4a0-4764f2b3f0d2