Claim total
$311.74
base $93.39 · payer covered $261.74
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-11-26
- Stop
- 2022-11-26
The parties
- Patient
- patient Martín Ramón Chacón
- Provider
- provider Trinity Mraz
- Payer
- payer Medicaid
Record id
0b2edf0d-f30f-28e2-17d9-017b85b76895