Claim total
$168.66
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-10-20
- Stop
- 2020-10-20
The parties
- Patient
- patient Briana Alana Hickle
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Anthem
Record id
0b3b7c16-0bc2-6fa5-c058-458b4342678a