Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2021-06-04
- Stop
- 2021-06-05
The parties
- Patient
- patient Loma Tawanna Ferry
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicare
Record id
04384da7-7311-e99a-e8f8-b6b1861876f6