Claim total
$19,588.09
base $127.17 · payer covered $19,538.09
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2021-02-02
- Stop
- 2021-02-03
The parties
- Patient
- patient Fredericka Eusebia Fadel
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
241eb205-3dd5-3858-0f29-ca657f08ac06