Claim total
$3,935.75
base $127.17 · payer covered $3,148.60
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2023-12-01
- Stop
- 2023-12-01
The parties
- Patient
- patient Blanche Bernier
- Provider
- provider Concepción Baeza
- Care site
- care site GOOD SAMARITAN AMBASSADOR
- Payer
- payer Medicare
Record id
2c01101e-9e7a-a6ae-7c36-fb8f33e2cc7f