Claim total
$711.08
base $93.39 · payer covered $661.08
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-06-27
- Stop
- 2017-06-27
The parties
- Patient
- patient Elisha Lucius Beer
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
0c3eaedd-0713-a0ea-f66f-369316fd7456