Claim total
$2,877.03
base $93.39 · payer covered $2,827.03
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-01-17
- Stop
- 2020-01-17
The parties
- Patient
- patient Xuan Clyde Glover
- Provider
- provider Adrienne Hills
- Payer
- payer Medicaid
Record id
126205ae-f6d6-030f-355f-23d408fee4cd