Claim total
$14,037.33
base $127.17 · payer covered $11,229.87
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2017-06-28
- Stop
- 2017-06-28
The parties
- Patient
- patient Jessie Raphael Sporer
- Provider
- provider Niesha Walter
- Payer
- payer Medicare
Record id
1bf8c6cb-7555-e1c3-08be-484da2589bd5