Claim total
$6,117.56
base $127.17 · payer covered $6,067.56
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2020-01-04
- Stop
- 2020-01-04
The parties
- Patient
- patient Elliott Crooks
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
016f6acf-14e3-04d0-2a4f-030822e458d0