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
- 2018-03-16
- Stop
- 2018-03-16
The parties
- Patient
- patient August Darrel Dach
- Provider
- provider Evalyn Torphy
- Care site
- care site ALLIANCE HHC & NURSING SERVICE
- Payer
- payer Medicaid
Record id
092b8bdc-b84a-4582-0ef1-5616e21f5f71