Claim total
$3,223.62
base $93.39 · payer covered $3,173.62
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 1982-07-04
- Stop
- 1982-07-04
The parties
- Patient
- patient Buddy Bradly Bradtke
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
207161b0-f503-ec70-9c00-43b60c4bf5c6