Claim total
$650.48
base $93.39 · payer covered $600.48
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-06-19
- Stop
- 2021-06-19
The parties
- Patient
- patient Tyrone Gerry Nolan
- Provider
- provider Jonas Pouros
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
0372df5d-1b51-df61-06a4-2454d8a10f04