Claim total
$710.08
base $93.39 · payer covered $653.40
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-09-29
- Stop
- 2024-09-29
The parties
- Patient
- patient Serina Rosaline Heller
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
17d8c763-cedc-a3c7-ee0e-6e6f999f00e6