Claim total
$4,693.77
base $127.17 · payer covered $4,658.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2022-01-18
- Stop
- 2022-01-18
The parties
- Patient
- patient Ezekiel Demarcus Roob
- Provider
- provider Claudia Bauch
- Care site
- care site THE VILLA AT ST LOUIS PARK
- Payer
- payer Dual Eligible
Record id
2e1a22fb-46ba-3fcc-dfe7-c064598cb9a6