Claim total
$2,601.09
base $93.39 · payer covered $2,551.09
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-04-02
- Stop
- 2022-04-02
The parties
- Patient
- patient Herb Shelton Dooley
- Provider
- provider Michael Dibbert
- Payer
- payer Medicaid
Record id
1a07e468-6352-fe11-6b2a-03f62713541a