Claim total
$684.16
base $93.39 · payer covered $649.16
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2023-12-17
- Stop
- 2023-12-17
The parties
- Patient
- patient Sha Kohler
- Provider
- provider Leta Sipes
- Payer
- payer Dual Eligible
Record id
19dce853-ad87-d82e-fa0c-4c12b639d08e