Claim total
$12,330.58
base $127.17 · payer covered $12,280.58
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2025-09-20
- Stop
- 2025-09-20
The parties
- Patient
- patient Alpha Fahey
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
0d312bb0-9f0e-a43d-9ea8-61000af76218