Claim total
$304.83
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-11-22
- Stop
- 2022-11-22
The parties
- Patient
- patient Joetta Antonette Bednar
- Provider
- provider Charlena Adams
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Cigna Health
Record id
2cb8de01-f198-8fe9-3285-75b7a352a21e