Claim total
$127.17
base $127.17 · payer covered $92.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2017-05-25
- Stop
- 2017-05-26
The parties
- Patient
- patient Edwardo Baumbach
- Provider
- provider Concepción Baeza
- Care site
- care site GOOD SAMARITAN AMBASSADOR
- Payer
- payer Dual Eligible
Record id
10e41b04-0f54-fb52-a01e-94a3771fe1bd