Claim total
$2,601.09
base $93.39 · payer covered $1,701.46
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-03-28
- Stop
- 2019-03-28
The parties
- Patient
- patient Gordon Hayden Herman
- Provider
- provider Charlena Adams
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Anthem
Record id
1841ad6f-b8a3-ad57-0f7c-db0f0de74b83