Claim total
$4,009.82
base $127.17 · payer covered $3,859.82
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- —
- Start
- 1992-11-19
- Stop
- 1992-11-19
The parties
- Patient
- patient Adina Jerlene Baumbach
- Provider
- provider Juli Predovic
- Care site
- care site KINDRED AT HOME
- Payer
- payer Medicaid
Record id
13decf1b-6d14-8aef-67b0-5ddbdace6ae1