Claim total
$12,904.12
base $127.17 · payer covered $12,854.12
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2020-10-02
- Stop
- 2020-10-02
The parties
- Patient
- patient Herb Shelton Dooley
- Provider
- provider Reginald Bruen
- Payer
- payer Medicaid
Record id
1a07e468-6352-fe11-9138-dab5b99b2f11