Claim total
$15,361.54
base $127.17 · payer covered $15,244.29
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2020-10-07
- Stop
- 2020-10-07
The parties
- Patient
- patient Elfreda Lonna Reichert
- Provider
- provider Evalyn Torphy
- Care site
- care site ALLIANCE HHC & NURSING SERVICE
- Payer
- payer Medicaid
Record id
179f37af-fa81-07e9-5770-fe67df4c1973