Claim total
$337.91
base $93.39 · payer covered $254.36
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2016-10-05
- Stop
- 2016-10-05
The parties
- Patient
- patient Sarah Grace Rodriguez
- Provider
- provider Dorethea Predovic
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Medicare
Record id
0b148eae-85bf-c41d-6f3c-ea3d2f5137ea