Claim total
$310.66
base $93.39 · payer covered $310.66
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 1997-07-29
- Stop
- 1997-07-29
The parties
- Patient
- patient Ty Orville Zemlak
- Provider
- provider Michael Dibbert
- Payer
- payer UnitedHealthcare
Record id
321c72ca-8c08-fd89-7d55-80cdc82ff76a