Claim total
$439.78
base $93.39 · payer covered $404.78
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2025-05-13
- Stop
- 2025-05-13
The parties
- Patient
- patient Woodrow Brett Bruen
- Provider
- provider Hazel Effertz
- Payer
- payer Dual Eligible
Record id
19bee1be-920a-c2f2-8a17-c4ac4a629a62