Claim total
$10,304.35
base $127.17 · payer covered $10,254.35
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2023-11-06
- Stop
- 2023-11-06
The parties
- Patient
- patient Aubrey Sal Champlin
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
1bcbe4dd-bbdd-c343-43ae-97a692c07513