Claim total
$3,223.62
base $93.39 · payer covered $3,173.62
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-11-13
- Stop
- 2024-11-13
The parties
- Patient
- patient Grace Marybelle Kuvalis
- Provider
- provider Janette Fisher
- Payer
- payer Medicaid
Record id
35646793-8e5d-1241-b336-fe659518b982