Claim total
$265.71
base $93.39 · payer covered $212.57
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2014-08-24
- Stop
- 2014-08-24
The parties
- Patient
- patient Jody Shoshana Powlowski
- Provider
- provider Trinidad Quitzon
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicare
Record id
226e0527-4c40-2548-d0ec-734b45f94016