Claim total
$5,666.76
base $127.17 · payer covered $5,616.76
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2020-10-06
- Stop
- 2020-10-06
The parties
- Patient
- patient Heath Cleo Dicki
- Provider
- provider Juli Predovic
- Care site
- care site KINDRED AT HOME
- Payer
- payer Medicaid
Record id
1d824c5f-111e-26ef-5733-25267ee901e1