Claim total
$126.29
base $93.39 · payer covered $101.03
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2025-04-11
- Stop
- 2025-04-11
The parties
- Patient
- patient Oscar Ricky Gerlach
- Provider
- provider Wes Jast
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicare
Record id
2dbeb246-a994-b355-1b5d-0b0a15055b8e