Claim total
$3,072.00
base $93.39 · payer covered $3,022.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-12-15
- Stop
- 2022-12-15
The parties
- Patient
- patient Novella Consuelo Nicolas
- Provider
- provider Michael Dibbert
- Payer
- payer Medicaid
Record id
073c3e67-985b-6205-e969-6234bf412c23