Claim total
$3,935.75
base $127.17 · payer covered $2,294.54
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2019-01-26
- Stop
- 2019-01-26
The parties
- Patient
- patient Ike Branden Moore
- Provider
- provider Juli Predovic
- Care site
- care site KINDRED AT HOME
- Payer
- payer Anthem
Record id
2d876bca-be8f-2e05-3dad-65260d60d693