Claim total
$2,601.09
base $93.39 · payer covered $2,498.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-12-30
- Stop
- 2021-12-30
The parties
- Patient
- patient Jarod Clyde Sipes
- Provider
- provider Hassie Beer
- Payer
- payer Medicaid
Record id
32122cd6-5f93-fb84-d1e7-84572a304279