Claim total
$3,293.75
base $93.39 · payer covered $3,243.75
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-05-26
- Stop
- 2017-05-26
The parties
- Patient
- patient Mikel Edmond Wisoky
- Provider
- provider Michael Dibbert
- Payer
- payer Medicaid
Record id
2973ea9a-f1cd-e339-e23f-15590b785e3e