Claim total
$164.10
base $93.39 · payer covered $114.10
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-09-23
- Stop
- 2020-09-23
The parties
- Patient
- patient Dahlia Taren Roberts
- Provider
- provider Adrienne Hills
- Payer
- payer Medicaid
Record id
21cb4452-b958-9992-49af-cdec042df0ca