Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2001-11-25
- Stop
- 2001-11-25
The parties
- Patient
- patient Tynisha Kerri Padberg
- Provider
- provider Emmanuel Champlin
- Care site
- care site CREST VIEW HOME HEALTH CARE
- Payer
- payer Medicare
Record id
27af11aa-2603-d62b-38f4-1c3a3cdd931d