Claim total
$742.16
base $93.39 · payer covered $692.16
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2015-06-04
- Stop
- 2015-06-04
The parties
- Patient
- patient Coleen Hester Boyle
- Provider
- provider Hassie Beer
- Payer
- payer Medicaid
Record id
1fee85c9-7061-f223-4247-4c3515b42543