Claim total
$701.09
base $93.39 · payer covered $651.09
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2025-07-19
- Stop
- 2025-07-19
The parties
- Patient
- patient Cedric Mathew Konopelski
- Provider
- provider Adrienne Hills
- Payer
- payer Medicaid
Record id
07a5fe6c-a44f-5fdc-c3f5-e971778d8491