Claim total
$564.33
base $93.39 · payer covered $514.33
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2016-07-30
- Stop
- 2016-07-30
The parties
- Patient
- patient Lashawna Schmeler
- Provider
- provider Jo Stiedemann
- Payer
- payer Medicaid
Record id
33a13641-be1f-aeac-467c-21e0187e1290