Claim total
$6,189.82
base $127.17 · payer covered $6,139.82
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2017-12-13
- Stop
- 2017-12-13
The parties
- Patient
- patient Karrie Lilia Reilly
- Provider
- provider Bennie O'Keefe
- Payer
- payer Medicaid
Record id
202e9677-3231-9e70-b7f4-9cfa802eaba9