Claim total
$310.31
base $93.39 · payer covered $260.31
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-05-31
- Stop
- 2022-05-31
The parties
- Patient
- patient Benito Delao
- Provider
- provider Jonas Pouros
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
30bb6e62-6649-f6c6-418f-6919820df685