Claim total
$195.02
base $93.39 · payer covered $156.01
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2016-05-03
- Stop
- 2016-05-03
The parties
- Patient
- patient Karen Yesenia Ledner
- Provider
- provider Simon Bode
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicare
Record id
13beb361-b7b4-8b75-2c5f-e22dc52c4f77