Claim total
$229.76
base $93.39 · payer covered $179.76
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-02-12
- Stop
- 2022-02-12
The parties
- Patient
- patient Teofila Virgina Tremblay
- Provider
- provider Antonetta Lubowitz
- Payer
- payer Medicaid
Record id
2571e7af-af29-523c-0c14-8486c9c50d5d