Claim total
$6,683.67
base $93.39 · payer covered $4,284.65
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-07-31
- Stop
- 2022-07-31
The parties
- Patient
- patient Joaquin Adalberto Wisoky
- Provider
- provider Clyde Beier
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Anthem
Record id
0cbeb834-403c-2bde-d470-2508c7de2c31