Claim total
$751.47
base $93.39 · payer covered $701.47
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-05-05
- Stop
- 2020-05-05
The parties
- Patient
- patient Raleigh Marlon Quitzon
- Provider
- provider Richard Ledner
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
36d18d55-3a3e-3ebd-4e5d-f552b43bed6c