Claim total
$126.29
base $93.39 · payer covered $91.29
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 1999-10-03
- Stop
- 1999-10-03
The parties
- Patient
- patient Elden Cary DuBuque
- Provider
- provider Kim Lind
- Payer
- payer Dual Eligible
Record id
2f6fe81f-21ca-2f76-33d6-da36e47ef1ee