Claim total
$15,361.54
base $127.17 · payer covered $15,326.54
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2017-04-19
- Stop
- 2017-04-19
The parties
- Patient
- patient Edgar Herzog
- Provider
- provider Grant Miller
- Care site
- care site OUR LADY OF PEACE HOME CARE
- Payer
- payer Dual Eligible
Record id
1f5e460e-a26c-0249-15f2-8fbcecf75b09