Claim total
$641.76
base $93.39 · payer covered $513.41
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-05-29
- Stop
- 2018-05-29
The parties
- Provider
- provider Hazel Effertz
- Payer
- payer Medicare
Record id
23088664-4c85-2fc4-da4b-5108afb705b6