Claim total
$3,406.91
base $93.39 · payer covered $3,356.91
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-10-12
- Stop
- 2019-10-12
The parties
- Patient
- patient Waltraud Tromp
- Provider
- provider Pasquale Grimes
- Payer
- payer Medicaid
Record id
1461ae1d-c357-fb97-2a70-8b2fbd1ca0e5