Claim total
$277.39
base $93.39 · payer covered $221.91
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-12-26
- Stop
- 2019-12-26
The parties
- Patient
- patient Andrea Chris Lebsack
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Anthem
Record id
1759b87f-1a83-c024-dcd2-d443bc636f18