Claim total
$326.89
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2023-07-04
- Stop
- 2023-07-04
The parties
- Patient
- patient Helga Darci Dicki
- Provider
- provider Donette Hilpert
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Anthem
Record id
232ea8f4-93f6-3362-a5c4-3bd0c6e11a77