Claim total
$8,495.53
base $127.17 · payer covered $8,445.53
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2018-06-22
- Stop
- 2018-06-22
The parties
- Patient
- patient Johnsie Jennie Sipes
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
38947f55-f973-1892-7f54-808e9f74d9d3