Claim total
$12,202.32
base $127.17 · payer covered $3,879.72
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2017-11-15
- Stop
- 2017-11-15
The parties
- Patient
- patient Humberto Hackett
- Provider
- provider Britt Borer
- Care site
- care site OUR LADY OF PEACE HOSPICE
- Payer
- payer Humana
Record id
28b97195-4a3c-8c0a-b75a-68a36c48aede