Claim total
$10,124.19
base $93.39 · payer covered $10,074.19
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2023-02-07
- Stop
- 2023-02-07
The parties
- Patient
- patient Humberto Milo Mitchell
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
1f081ea7-4272-5474-d979-c30f6559fb49