Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-05-03
- Stop
- 2022-05-03
The parties
- Patient
- patient Marcelo Roland Daniel
- Provider
- provider Hollie Sawayn
- Payer
- payer Dual Eligible
Record id
172af60a-c1b7-eaec-8c53-7e5473ce3be9