Claim total
$3,935.75
base $127.17 · payer covered $3,885.75
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2021-09-07
- Stop
- 2021-09-07
The parties
- Provider
- provider Marquerite Swaniawski
- Payer
- payer Medicaid
Record id
010d736c-d81f-3cd7-1dab-03bbc6c2ed4d