Claim total
$172.36
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2015-12-06
- Stop
- 2015-12-06
The parties
- Patient
- patient Rene Braun
- Provider
- provider Joshua Dickens
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer UnitedHealthcare
Record id
19754690-fe19-5759-5339-d413e045f4cd