Claim total
$4,851.93
base $127.17 · payer covered $4,801.93
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2021-09-11
- Stop
- 2021-09-11
The parties
- Patient
- patient Myrtle Tana Casper
- Provider
- provider Evalyn Torphy
- Care site
- care site ALLIANCE HHC & NURSING SERVICE
- Payer
- payer Medicaid
Record id
2a4c8829-e297-058f-c194-d25f8d2d7c13