Claim total
$373.52
base $93.39 · payer covered $323.52
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2015-11-11
- Stop
- 2015-11-11
The parties
- Patient
- patient Dolores Elvira Cavazos
- Provider
- provider María Soledad Archuleta
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
322b2c58-05f4-c3ad-6925-949850c0329b