Claim total
$239.14
base $93.39 · payer covered $189.14
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2025-12-10
- Stop
- 2025-12-10
The parties
- Patient
- patient Arlette Soledad Cremin
- Provider
- provider Michael Dibbert
- Payer
- payer Medicaid
Record id
1af9c94d-34ef-178e-84a7-c9c013ae0531