Claim total
$3,996.35
base $127.17 · payer covered $3,961.35
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2022-04-15
- Stop
- 2022-04-15
The parties
- Patient
- patient Wilfred Dylan Stracke
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Dual Eligible
Record id
12af9e1b-7bdb-0614-03b5-6b6bc83f0568