Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2024-12-12
- Stop
- 2024-12-12
The parties
- Patient
- patient Cara Twana Rohan
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
36e78c82-a2fb-ce3c-9af6-af548d6b6352