Claim total
$5,179.77
base $127.17 · payer covered $4,143.82
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2020-05-02
- Stop
- 2020-05-02
The parties
- Patient
- patient Kim Edmundo Rolfson
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicare
Record id
03d7ab8f-b989-4d49-a930-e54057b0dd64