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
- 2018-03-06
- Stop
- 2018-03-06
The parties
- Patient
- patient Cory Irwin Bergnaum
- Provider
- provider Rashad Wilderman
- Care site
- care site EVERYTIME HOME CARE
- Payer
- payer Medicaid
Record id
0a80947b-a6e7-a756-8e4b-e49ea9844b6c