Claim total
$321.13
base $93.39 · payer covered $271.13
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2009-09-27
- Stop
- 2009-09-27
The parties
- Patient
- patient Quintin Loyd Ullrich
- Provider
- provider Andria Spinka
- Payer
- payer Medicaid
Record id
33a68753-f79f-bb9d-1d9b-f90d5908bae9