Claim total
$505.30
base $93.39 · payer covered $455.30
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-03-15
- Stop
- 2019-03-15
The parties
- Patient
- patient Sylvie Loma Bailey
- Provider
- provider Jo Stiedemann
- Payer
- payer Medicaid
Record id
10d68dd4-2444-6d0f-048d-6f34bf6757c7