Claim total
$949.77
base $127.17 · payer covered $914.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2022-11-23
- Stop
- 2022-12-05
The parties
- Patient
- patient Gabrielle Nidia Heller
- Provider
- provider Sheree Kreiger
- Care site
- care site MARANATHA CARE CENTER
- Payer
- payer Dual Eligible
Record id
12861e53-c53d-3b3d-cc3c-1bb349eced53