Claim total
$3,935.75
base $127.17 · payer covered $3,900.75
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2012-11-05
- Stop
- 2012-11-05
The parties
- Patient
- patient Nena Josephine Stehr
- Provider
- provider Davida Wolff
- Payer
- payer Dual Eligible
Record id
00eec58c-8547-4a29-c026-c840786ec580