Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2016-11-07
- Stop
- 2016-11-07
The parties
- Patient
- patient Bill Antonio Gleason
- Provider
- provider Leta Sipes
- Payer
- payer Dual Eligible
Record id
29eef510-cf92-084f-50af-2b284d79e596