Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-03-31
- Stop
- 2018-03-31
The parties
- Patient
- patient Adina Jerlene Baumbach
- Provider
- provider Pa Kulas
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
13decf1b-6d14-8aef-522f-b8646aedb5a7