Claim total
$251.39
base $93.39 · payer covered $201.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2009-06-05
- Stop
- 2009-06-05
The parties
- Patient
- patient Otis Jed Price
- Provider
- provider Janice Huel
- Payer
- payer Medicaid
Record id
1d8b9eda-b86e-378b-451b-891e11851612