Claim total
$3,869.18
base $93.39 · payer covered $2,104.55
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-03-14
- Stop
- 2024-03-14
The parties
- Patient
- patient Beula Shaunta Wiegand
- Provider
- provider Leta Sipes
- Payer
- payer Anthem
Record id
070984e6-7643-dc77-2f57-7c2fdebc15f9