Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-06-04
- Stop
- 2021-06-04
The parties
- Patient
- patient Lupe Lorenzo Brekke
- Provider
- provider Michael Dibbert
- Payer
- payer Medicaid
Record id
1816a270-2239-ee33-dd8d-c284f67dcde2