Claim total
$4,217.52
base $93.39 · payer covered $3,374.01
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-01-21
- Stop
- 2019-01-21
The parties
- Patient
- patient Jeanmarie Jann Bogisich
- Provider
- provider Jo Stiedemann
- Payer
- payer Medicare
Record id
17e1c4cb-44e4-7484-c0b0-c951eca67da7