Claim total
$231.27
base $93.39 · payer covered $76.70
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2004-04-10
- Stop
- 2004-04-10
The parties
- Patient
- patient Aurora Desire Raynor
- Provider
- provider Greta Gutmann
- Care site
- care site MERCY HOSPITAL
- Payer
- payer Medicare
Record id
124b3f89-9575-2f99-b6d6-89398e9a5fef