Claim total
$3,935.75
base $127.17 · payer covered $3,900.75
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 1991-04-30
- Stop
- 1991-04-30
The parties
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Dual Eligible
Record id
0126321a-a5af-784d-0ebf-b69459a0418c