Claim total
$915.99
base $93.39 · payer covered $765.99
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute viral pharyngitis195662009
- Start
- 2025-06-22
- Stop
- 2025-06-22
The parties
- Patient
- patient Dorotea Yolanda Palomo
- Provider
- provider Dale Mertz
- Payer
- payer Medicaid
Record id
04ad2732-b952-4fbb-394e-241d670af2a3