Claim total
$150.55
base $93.39 · payer covered $100.55
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-04-03
- Stop
- 2018-04-03
The parties
- Patient
- patient Salvador Hernán Marrero
- Provider
- provider Floyd Toy
- Payer
- payer Medicaid
Record id
003934f5-fa99-8d07-eb9e-78ba0cbcc184