Claim total
$128.34
base $93.39 · payer covered $78.34
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2026-01-28
- Stop
- 2026-01-28
The parties
- Patient
- patient Krista Jenniffer Kautzer
- Provider
- provider Antonetta Lubowitz
- Payer
- payer Medicaid
Record id
0f6846d9-5866-3324-40e3-e75a6f4af873