Claim total
$649.64
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-07-21
- Stop
- 2019-07-21
The parties
- Patient
- patient Manual Jack Rolfson
- Provider
- provider Leta Sipes
- Payer
- payer No insurance
Record id
08e1cdf3-4764-d0af-295a-134138e19d17