Claim total
$2,601.09
base $93.39 · payer covered $2,566.09
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-07-29
- Stop
- 2020-07-29
The parties
- Patient
- patient Leigha Sharleen Champlin
- Provider
- provider Marcus Douglas
- Payer
- payer Dual Eligible
Record id
2f4e5dee-d991-4c97-7cd3-0c218885a4aa