Claim total
$10,078.03
base $93.39 · payer covered $6,974.10
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2026-06-17
- Stop
- 2026-06-17
The parties
- Patient
- patient Claudio Jacinto Dicki
- Provider
- provider Trinidad Quitzon
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Anthem
Record id
120844ca-c593-fbeb-f345-b0ba0a34799c