Claim total
$5,402.71
base $127.17 · payer covered $5,402.71
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2006-10-08
- Stop
- 2006-10-08
The parties
- Patient
- patient Daniele Caryl Stracke
- Provider
- provider Britt Borer
- Care site
- care site OUR LADY OF PEACE HOSPICE
- Payer
- payer Humana
Record id
1727d1fa-71e1-4195-e5ad-7745044fa5d2