Claim total
$10,124.19
base $93.39 · payer covered $10,074.19
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2016-10-12
- Stop
- 2016-10-12
The parties
- Patient
- patient Wilfred Jeromy Nolan
- Provider
- provider Dale Mertz
- Payer
- payer Medicaid
Record id
339a5997-d469-f9bc-3c3a-1742ffcacbc3