Claim total
$1,178.45
base $93.39 · payer covered $1,128.45
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute viral pharyngitis195662009
- Start
- 2025-06-19
- Stop
- 2025-06-19
The parties
- Patient
- patient Joe Maximo Kozey
- Provider
- provider Cornelia Altenwerth
- Care site
- care site MERCY HOSPITAL
- Payer
- payer Medicaid
Record id
0135e6bd-cd4d-6318-db5e-b4a74e028d98