Claim total
$303.38
base $93.39 · payer covered $242.70
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-01-01
- Stop
- 2018-01-01
The parties
- Patient
- patient Ines Shiloh Jacobi
- Provider
- provider Pa Kulas
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Medicare
Record id
25075e04-8a2f-41db-4498-f901250673ae