Claim total
$12,614.31
base $93.39 · payer covered $12,564.31
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2012-11-18
- Stop
- 2012-11-18
The parties
- Patient
- patient Quintin Loyd Ullrich
- Provider
- provider Criselda Bartell
- Payer
- payer Medicaid
Record id
33a68753-f79f-bb9d-4d02-4347afd1ae23