Claim total
$141.35
base $93.39 · payer covered $71.49
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-09-13
- Stop
- 2021-09-13
The parties
- Patient
- patient Claudette Arlean Thiel
- Provider
- provider Adrienne Hills
- Payer
- payer Medicaid
Record id
39946394-5083-4083-7a02-0d11fdcac2f1