Claim total
$555.57
base $93.39 · payer covered $453.17
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2010-10-21
- Stop
- 2010-10-21
The parties
- Provider
- provider Trinity Mraz
- Payer
- payer Medicaid
Record id
27d44017-ab24-4e1b-3e16-b9f1d28c0fa9