Claim total
$12,902.57
base $127.17 · payer covered $12,852.57
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2020-10-08
- Stop
- 2020-10-08
The parties
- Patient
- patient Jon Lavern Baumbach
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
033f4a7e-c2bc-1f12-5183-5ae13cf13462