Claim total
$5,187.24
base $127.17 · payer covered $1,662.44
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2016-11-19
- Stop
- 2016-11-19
The parties
- Patient
- patient Jason Morris Braun
- Provider
- provider Emmanuel Champlin
- Care site
- care site CREST VIEW HOME HEALTH CARE
Record id
1d119b04-79c9-75fa-2968-ec7f58432083