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
- 2025-09-26
- Stop
- 2025-09-26
The parties
- Patient
- patient Coretta Philomena Boyle
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Dual Eligible
Record id
06293262-0c72-c029-8a64-c69d7d129277