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
- 2024-05-08
- Stop
- 2024-05-08
The parties
- Provider
- provider Avery VonRueden
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
383780d4-76d3-25d1-f4cf-852e6a0dae36