Claim total
$15,361.54
base $127.17 · payer covered $15,311.54
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2018-08-24
- Stop
- 2018-08-24
The parties
- Patient
- patient Marco Hong Zboncak
- Provider
- provider Reginald Bruen
- Payer
- payer Medicaid
Record id
2f19dc97-67f3-a9cc-e8c2-33a76c267515