Claim total
$6,464.27
base $127.17 · payer covered $6,414.27
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2018-05-13
- Stop
- 2018-05-13
The parties
- Patient
- patient Kylie Alysa Herzog
- Provider
- provider Allan Rowe
- Payer
- payer Medicaid
Record id
097fc80f-e956-12e7-7831-8bb7d50193fc