Claim total
$440.29
base $93.39 · payer covered $390.29
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 1977-10-01
- Stop
- 1977-10-01
The parties
- Patient
- patient Irving Steve Legros
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
02796652-7893-0df9-4fec-0f38c2ac0e3e