Claim total
$10,368.47
base $127.17 · payer covered $8,294.78
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Impacted molars196416002
- Start
- 1990-11-24
- Stop
- 1990-11-24
The parties
- Patient
- patient Harland Carmine Herzog
- Provider
- provider Sheree Kreiger
- Care site
- care site MARANATHA CARE CENTER
- Payer
- payer Medicare
Record id
0302711f-bc3a-898e-7abc-f0d223f4038c