Claim total
$454.62
base $93.39 · payer covered $363.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2007-02-02
- Stop
- 2007-02-02
The parties
- Patient
- patient Aurora Desire Raynor
- Provider
- provider Eldon Conn
- Care site
- care site MERCY HOSPITAL
- Payer
- payer Medicare
Record id
124b3f89-9575-2f99-e6b3-db97b727a4f1