Claim total
$217.87
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-10-13
- Stop
- 2020-10-13
The parties
- Patient
- patient Janna Etta Sipes
- Provider
- provider Avery VonRueden
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer UnitedHealthcare
Record id
21b17bd5-a058-5b07-780c-edfe1d60548f