Claim total
$3,918.22
base $93.39 · payer covered $3,868.22
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 1995-05-06
- Stop
- 1995-05-07
The parties
- Patient
- patient Enid Ignacia Barrows
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
2619cead-04c9-109e-7ca7-7434dae9df43