Claim total
$3,882.11
base $93.39 · payer covered $3,105.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 1985-04-20
- Stop
- 1985-04-20
The parties
- Patient
- patient Luigi Ezekiel Stehr
- Provider
- provider Hazel Effertz
- Payer
- payer Medicare
Record id
0f90eec3-ef36-aefd-2e2b-d73331c4df85