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
- 2019-05-15
- Stop
- 2019-05-15
The parties
- Patient
- patient Gilma Ivy Sporer
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
342f92f5-8a6e-b6a8-c0d2-254f13e790e9