Claim total
$3,935.75
base $127.17 · payer covered $3,935.75
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2015-05-08
- Stop
- 2015-05-08
The parties
- Patient
- patient Amelia Danyel Hintz
- Provider
- provider Allan Rowe
- Payer
- payer Humana
Record id
007ab53b-1293-c7a9-a38a-fc18cdf868e8