Claim total
$2,601.09
base $93.39 · payer covered $2,080.87
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2023-01-29
- Stop
- 2023-01-29
The parties
- Patient
- patient Antonia Palacios
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Anthem
Record id
3695eacd-d76f-1a40-5d66-6945cc438acc