Claim total
$5,088.88
base $127.17 · payer covered $5,053.88
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2020-07-07
- Stop
- 2020-07-07
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-d991-4c97-7d10-a70d5fe167f2