Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-10-28
- Stop
- 2018-10-28
The parties
- Patient
- patient Lupe Lorenzo Brekke
- Provider
- provider Antonetta Lubowitz
- Payer
- payer Dual Eligible
Record id
1816a270-2239-ee33-f9e4-7eac94ca266f