Claim total
$751.47
base $93.39 · payer covered $701.47
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-10-21
- Stop
- 2018-10-21
The parties
- Patient
- patient August Darrel Dach
- Provider
- provider Antonetta Lubowitz
- Payer
- payer Medicaid
Record id
092b8bdc-b84a-4582-6acb-8c40ba6c4c4f