Claim total
$582.62
base $93.39 · payer covered $532.62
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-08-12
- Stop
- 2017-08-12
The parties
- Patient
- patient Scott Macejkovic
- Provider
- provider Dorethea Predovic
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
19eb005b-03f8-dfb6-5de6-82b6e6ce6f7f