Claim total
$751.47
base $93.39 · payer covered $601.17
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-11-26
- Stop
- 2021-11-26
The parties
- Patient
- patient Heriberto Orval Feest
- Provider
- provider Leta Sipes
- Payer
- payer UnitedHealthcare
Record id
04dd6dd9-2faa-05da-166b-22f3bd07cdef