Claim total
$751.47
base $93.39 · payer covered $701.47
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-10-09
- Stop
- 2017-10-09
The parties
- Patient
- patient Delinda Patrica Turner
- Provider
- provider Adrienne Hills
- Payer
- payer Medicaid
Record id
073748e8-f10b-2b62-c668-64a45b0791c5