Claim total
$3,460.59
base $93.39 · payer covered $3,425.59
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2026-07-05
- Stop
- 2026-07-05
The parties
- Patient
- patient Adrian Arden Haag
- Provider
- provider Bethanie Wintheiser
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
341d0f9d-7d8e-e18c-150a-1809b3a8306d