Claim total
$126.29
base $93.39 · payer covered $76.29
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-08-24
- Stop
- 2021-08-24
The parties
- Patient
- patient Cecil Mitchell Price
- Provider
- provider Lady Frami
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
2d05c315-5062-3714-0dcd-775e63a81214