Claim total
$247.90
base $93.39 · payer covered $116.03
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-10-21
- Stop
- 2024-10-21
The parties
- Patient
- patient Gonzalo Jc Stark
- Provider
- provider Hazel Effertz
- Payer
- payer Medicare
Record id
35ecf519-d5db-5fe4-56e8-92a5ece79d52