Claim total
$3,935.75
base $127.17 · payer covered $3,885.75
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2022-10-03
- Stop
- 2022-10-03
The parties
- Patient
- patient Zachery Vincenzo Berge
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
01ce818c-8f9f-924a-29bf-c2b1785fc04e