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
- 2017-06-06
- Stop
- 2017-06-06
The parties
- Patient
- patient Suzi Sydney Robel
- Provider
- provider Marquerite Swaniawski
- Payer
- payer Medicaid
Record id
0804c552-c9d6-65d3-9ad2-1d89fe3d721a