Claim total
$915.99
base $93.39 · payer covered $765.99
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute viral pharyngitis195662009
- Start
- 2017-12-22
- Stop
- 2017-12-22
The parties
- Patient
- patient Annamarie Mollie Hoppe
- Provider
- provider Trinity Mraz
- Payer
- payer Medicaid
Record id
0555f11c-c453-57eb-93ac-2620a772bca1