Claim total
$76.30
base $76.30 · payer covered $26.30
The visit
- Class
- Emergency
- Code
- 183452005
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 1991-02-08
- Stop
- 1991-02-08
The parties
- Patient
- patient Efren Wilderman
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
0400ef40-232f-be7a-be5f-0b3791351457