Claim total
$3,603.80
base $93.39 · payer covered $3,553.80
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-08-27
- Stop
- 2017-08-27
The parties
- Patient
- patient Ned Connelly
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
1aa52c58-7283-34d6-6e4a-0da3d0f68aad