Claim total
$4,819.66
base $127.17 · payer covered $4,784.66
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2024-05-06
- Stop
- 2024-05-06
The parties
- Patient
- patient Elijah Ellis Skiles
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Dual Eligible
Record id
29599f43-c6ee-475e-b022-08386f4113a6