Claim total
$751.47
base $93.39 · payer covered $701.47
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2001-07-26
- Stop
- 2001-07-26
The parties
- Patient
- patient Benedict Alvin Armstrong
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
2c61caa8-0470-e3a1-324e-88400b83292c