Claim total
$949.77
base $127.17 · payer covered $899.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2024-09-21
- Stop
- 2024-09-28
The parties
- Patient
- patient Adolfo Clifford Okuneva
- Provider
- provider Bennie O'Keefe
- Payer
- payer Medicaid
Record id
117319ae-7a08-ce49-3d16-59bab1a66add