Claim total
$3,987.92
base $127.17 · payer covered $3,952.92
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- —
- Start
- 2013-10-25
- Stop
- 2013-10-25
The parties
- Patient
- patient Nena Josephine Stehr
- Provider
- provider Davida Wolff
- Payer
- payer Dual Eligible
Record id
00eec58c-8547-4a29-28a1-6e0e0c7cdfdd