Claim total
$6,822.58
base $127.17 · payer covered $6,725.12
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2026-06-11
- Stop
- 2026-06-11
The parties
- Patient
- patient Branden Milford Ullrich
- Provider
- provider Grant Miller
- Care site
- care site OUR LADY OF PEACE HOME CARE
- Payer
- payer Medicaid
Record id
10ef12fb-14dc-88af-a127-1dd0ccf1bb46