Claim total
$2,601.09
base $93.39 · payer covered $2,551.09
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-06-13
- Stop
- 2019-06-13
The parties
- Patient
- patient Ezekiel Demarcus Roob
- Provider
- provider Liz Kozey
- Payer
- payer Medicaid
Record id
2e1a22fb-46ba-3fcc-0654-d5efb4ddc709