Claim total
$201.74
base $93.39 · payer covered $142.57
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-11-02
- Stop
- 2021-11-02
The parties
- Patient
- patient Stevie Gorczany
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
1cb87270-7b3e-ee91-7d5b-0622e229b7ec