Claim total
$518.80
base $93.39 · payer covered $468.80
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-08-09
- Stop
- 2017-08-09
The parties
- Patient
- patient Jesse Roosevelt Wolf
- Provider
- provider Viviana Aufderhar
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
26aa011e-0d75-d1a3-4fa7-3f87742a0e18