Claim total
$240.79
base $93.39 · payer covered $192.63
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-02-25
- Stop
- 2019-02-25
The parties
- Patient
- patient Ismael Rodger Pagac
- Provider
- provider Leta Sipes
- Payer
- payer Medicare
Record id
1c5112f3-9ebe-219f-e340-f30dd2ecdc90