Claim total
$2,936.93
base $93.39 · payer covered $2,068.12
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-03-12
- Stop
- 2017-03-12
The parties
- Patient
- patient Beula Robert Kirlin
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Anthem
Record id
3a749fce-e180-5b8b-dac7-61515286f4fd