Claim total
$169.77
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-01-15
- Stop
- 2024-01-15
The parties
- Patient
- patient Athena Scarlet Reynolds
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Anthem
Record id
37e9fb27-a6fc-de33-1bcd-4a2443ebd607