Claim total
$410.81
base $93.39 · payer covered $328.65
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 1992-08-12
- Stop
- 1992-08-12
The parties
- Patient
- patient Jimmie Micah Predovic
- Provider
- provider Leta Sipes
- Payer
- payer Medicare
Record id
2c84ecc3-1d6b-8ca5-3c6d-fec9b751e68f