Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2025-12-26
- Stop
- 2025-12-26
The parties
- Patient
- patient Percy Dwight Hamill
- Provider
- provider Dale Mertz
- Payer
- payer Medicaid
Record id
2a6420b9-f515-a0d3-af3c-dbd264a23778