Claim total
$3,935.75
base $127.17 · payer covered $3,885.75
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2017-10-08
- Stop
- 2017-10-08
The parties
- Patient
- patient Jacquiline Blanch Bode
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
2940605a-f91c-d361-a401-6282e9817bfb