Claim total
$5,048.62
base $127.17 · payer covered $664.64
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Impacted molars196416002
- Start
- 2013-01-13
- Stop
- 2013-01-13
The parties
- Patient
- patient Angelo Muller
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Humana
Record id
036bf274-5bd6-d003-c1bb-d0f442f868c5