Claim total
$751.47
base $93.39 · payer covered $701.47
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2023-05-22
- Stop
- 2023-05-22
The parties
- Patient
- patient Serina Rosaline Heller
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
17d8c763-cedc-a3c7-a358-14cf19d36013