Claim total
$15,361.54
base $127.17 · payer covered $15,361.54
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2024-03-22
- Stop
- 2024-03-22
The parties
- Patient
- patient Shakira Toccara Stamm
- Provider
- provider Bennie O'Keefe
- Payer
- payer Humana
Record id
3921b8e6-ecee-d231-a7b5-3b7aef1eeeec