Claim total
$247.19
base $93.39 · payer covered $197.19
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-08-21
- Stop
- 2024-08-21
The parties
- Patient
- patient Susanne Jenna Hahn
- Provider
- provider Trinity Mraz
- Payer
- payer Medicaid
Record id
0ba36fae-b9a3-10c0-c675-6f083205b4df