Claim total
$5,595.64
base $127.17 · payer covered $3,388.19
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2018-06-19
- Stop
- 2018-06-19
The parties
- Patient
- patient Huong Verla Wilderman
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Anthem
Record id
3457d972-15d5-e8c6-e5e2-ca81f58b32fc