Claim total
$309.41
base $93.39 · payer covered $259.41
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2023-08-24
- Stop
- 2023-08-24
The parties
- Patient
- patient Jarod Clyde Sipes
- Provider
- provider Janette Fisher
- Payer
- payer Medicaid
Record id
32122cd6-5f93-fb84-7b61-e73af207b023