Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2019-04-15
- Stop
- 2019-04-15
The parties
- Patient
- patient Leroy Javier Batz
- Provider
- provider Britt Borer
- Care site
- care site OUR LADY OF PEACE HOSPICE
- Payer
- payer Humana
Record id
2c19b131-403a-5087-9d75-fefc93aab742