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
- 2020-05-19
- Stop
- 2020-05-19
The parties
- Patient
- patient Kylie Alysa Herzog
- Provider
- provider Allan Rowe
- Payer
- payer Medicaid
Record id
097fc80f-e956-12e7-6fc8-d7b8783345cd