Claim total
$8,787.47
base $127.17 · payer covered $8,737.47
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2017-02-27
- Stop
- 2017-02-27
The parties
- Patient
- patient Adolfo Clifford Okuneva
- Provider
- provider Bennie O'Keefe
- Payer
- payer Medicaid
Record id
117319ae-7a08-ce49-0837-65cd7f8a6f5c