Claim total
$10,124.19
base $93.39 · payer covered $10,089.19
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-05-20
- Stop
- 2017-05-20
The parties
- Patient
- patient Woodrow Brett Bruen
- Provider
- provider Hazel Effertz
- Payer
- payer Dual Eligible
Record id
19bee1be-920a-c2f2-acd4-ad52a46620f9