Claim total
$4,102.67
base $93.39 · payer covered $4,052.67
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-04-26
- Stop
- 2020-04-26
The parties
- Patient
- patient Walter Rudolph Little
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
361a4d7c-124b-a34d-0612-eacbcbae714f