Claim total
$507.45
base $93.39 · payer covered $304.47
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-08-06
- Stop
- 2024-08-06
The parties
- Patient
- patient Edie Victoria Zulauf
- Provider
- provider Adrienne Hills
- Payer
- payer Humana
Record id
2fbaa88f-9da9-5871-a0c0-4babd606771b