Claim total
$7,688.21
base $93.39 · payer covered $7,638.21
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-11-06
- Stop
- 2024-11-06
The parties
- Patient
- patient Jacobo Homero Zaragoza
- Provider
- provider Keneth Will
- Care site
- care site MERCY HOSPITAL
- Payer
- payer Medicaid
Record id
3801a1fa-983c-995f-5ae1-528d4b0bf7a8