Claim total
$4,417.54
base $93.39 · payer covered $658.36
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-01-12
- Stop
- 2021-01-12
The parties
- Patient
- patient Perry Johnson Conn
- Provider
- provider Trinidad Quitzon
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
222e3254-e0eb-5bb2-74c0-f02eb515423f