Claim total
$126.29
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2025-04-07
- Stop
- 2025-04-07
The parties
- Patient
- patient Jackeline Becker
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
0ac63550-d2bd-cff8-239a-9b322185c272