Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2025-12-04
- Stop
- 2025-12-04
The parties
- Patient
- patient Starr Chun Hackett
- Provider
- provider Claudia Bauch
- Care site
- care site THE VILLA AT ST LOUIS PARK
- Payer
- payer Medicaid
Record id
2eeb7532-520e-d315-d050-1cce1505950c