Claim total
$173.98
base $93.39 · payer covered $123.98
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2025-06-07
- Stop
- 2025-06-07
The parties
- Patient
- patient Carlotta Arthur Bradtke
- Provider
- provider Antonetta Lubowitz
- Payer
- payer Medicaid
Record id
326580b5-448f-6772-5a58-93078416102d