Claim total
$460.55
base $93.39 · payer covered $425.55
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-05-06
- Stop
- 2020-05-06
The parties
- Patient
- patient Natacha Mertz
- Provider
- provider Trinity Mraz
- Payer
- payer Dual Eligible
Record id
26aae4f1-7e29-a4a4-5c0d-afd6f39527a6