Claim total
$751.47
base $93.39 · payer covered $701.47
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-01-31
- Stop
- 2019-01-31
The parties
- Patient
- patient Deangelo Nienow
- Provider
- provider Malena Wilderman
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
2bbd76b7-e9a4-0597-0d60-0387d3c0bf4a