Claim total
$560.15
base $93.39 · payer covered $525.15
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2023-11-20
- Stop
- 2023-11-20
The parties
- Patient
- patient Mallory Bobette Stehr
- Provider
- provider Burton O'Conner
- Payer
- payer Dual Eligible
Record id
0ebd7f5a-eab8-697e-d00a-2eabfe573740