Claim total
$638.89
base $93.39 · payer covered $603.89
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-10-19
- Stop
- 2017-10-19
The parties
- Patient
- patient Lacy Schumm
- Provider
- provider Kelvin Reichel
- Payer
- payer Dual Eligible
Record id
1b98fd26-00a1-c39a-dccd-68d89a9634a0