Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2016-10-20
- Stop
- 2016-10-20
The parties
- Patient
- patient Eda So Mante
- Provider
- provider Britt Borer
- Care site
- care site OUR LADY OF PEACE HOSPICE
- Payer
- payer UnitedHealthcare
Record id
2a79084b-df5c-41f9-9f90-3b4ab45c6827