Claim total
$704.32
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-10-28
- Stop
- 2018-10-28
The parties
- Patient
- patient Nona Samara Gleichner
- Provider
- provider Trinity Mraz
- Payer
- payer Humana
Record id
0042ca65-dd9d-7221-5795-665615518c3d