Claim total
$101.32
base $93.39 · payer covered $51.32
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bacterial sinusitis75498004
- Start
- 2005-05-08
- Stop
- 2005-05-08
The parties
- Patient
- patient Sha Robin Reilly
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
043d6e13-0cc7-07f3-99f5-3368e2d2fcb1