Claim total
$751.47
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-03-21
- Stop
- 2019-03-21
The parties
- Patient
- patient Gene Josh Gottlieb
- Provider
- provider Celesta Shields
- Care site
- care site MERCY HOSPITAL
- Payer
- payer No insurance
Record id
1fc3953b-cadf-1416-207a-dc534fc11deb