Claim total
$390.82
base $93.39 · payer covered $340.82
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-10-02
- Stop
- 2022-10-02
The parties
- Patient
- patient Amado Antwan Botsford
- Provider
- provider Antonetta Lubowitz
- Payer
- payer Medicaid
Record id
2217599d-1482-7c06-d38c-74ec51777478