Claim total
$10,605.45
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Impacted molars196416002
- Start
- 1991-02-19
- Stop
- 1991-02-19
The parties
- Patient
- patient Loma Tawanna Ferry
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer No insurance
Record id
04384da7-7311-e99a-de4b-74b61a3f5cbe