Claim total
$12,614.31
base $93.39 · payer covered $12,564.31
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-05-08
- Stop
- 2020-05-08
The parties
- Patient
- patient Isela Lisbeth Lang
- Provider
- provider Trinity Mraz
- Payer
- payer Medicaid
Record id
310def7b-a5c6-df96-03a8-a9031eaa56e4