Claim total
$134.22
base $93.39 · payer covered $107.37
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-06-10
- Stop
- 2022-06-10
The parties
- Patient
- patient Jose Tanner Jakubowski
- Provider
- provider Burton O'Conner
- Payer
- payer UnitedHealthcare
Record id
17e9a58b-659f-915c-bc24-bfeda0178ea4