Claim total
$5,486.27
base $127.17 · payer covered $5,383.87
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2024-01-06
- Stop
- 2024-01-06
The parties
- Patient
- patient Kam Ching Pollich
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
0681ce4b-c984-7822-a164-cd7a4683d99e