Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-04-10
- Stop
- 2024-04-10
The parties
- Patient
- patient Bob Sergio O'Hara
- Provider
- provider Criselda Bartell
- Payer
- payer Dual Eligible
Record id
261c034c-cc44-5f0f-54be-07efaadf7a1b