Claim total
$127.17
base $127.17 · payer covered $57.31
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 1952-07-04
- Stop
- 1952-07-04
The parties
- Patient
- patient Toshiko Sybil King
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
106257f3-21d9-7a09-8929-26358bcbf8bd