Claim total
$538.47
base $127.17 · payer covered $503.47
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Gunshot wound283545005
- Start
- 2022-08-02
- Stop
- 2022-08-02
The parties
- Patient
- patient Leigha Sharleen Champlin
- Provider
- provider Rashad Wilderman
- Care site
- care site EVERYTIME HOME CARE
- Payer
- payer Dual Eligible
Record id
2f4e5dee-d991-4c97-4536-ebc252f1241d