Claim total
$174.62
base $93.39 · payer covered $174.62
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-07-28
- Stop
- 2022-07-28
The parties
- Patient
- patient Wonda Shields
- Provider
- provider Charlie Tillman
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer UnitedHealthcare
Record id
33704fef-efb6-c12c-78a8-178b7f393667