Claim total
$3,125.16
base $93.39 · payer covered $3,075.16
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2023-12-15
- Stop
- 2023-12-15
The parties
- Patient
- patient Sherryl Dion Collier
- Provider
- provider Irmgard Padberg
- Payer
- payer Medicaid
Record id
2ff124fd-32f0-2d7e-6eff-7a1d8f247663