Claim total
$5,533.75
base $93.39 · payer covered $2,126.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2025-07-11
- Stop
- 2025-07-11
The parties
- Patient
- patient Lucia Claudia Gonzales
- Provider
- provider Joshua Dickens
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Cigna Health
Record id
0d82452b-5d70-c48a-8f55-5b3948e5d7de