Claim total
$1,801.87
base $93.39 · payer covered $1,441.49
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Acute infective cystitis307426000
- Start
- 2022-05-25
- Stop
- 2022-05-25
The parties
- Patient
- patient Rosario Jim Braun
- Provider
- provider Criselda Bartell
- Payer
- payer Medicare
Record id
023d14fa-8b29-07fb-2f5d-e9ca500836e7