Claim total
$141.68
base $93.39 · payer covered $141.68
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-09-22
- Stop
- 2022-09-22
The parties
- Patient
- patient Masako Leonore Dibbert
- Provider
- provider Pasquale Grimes
- Payer
- payer Aetna
Record id
239ee417-8147-4096-62a6-cbf2b5fe7d8a