Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2020-12-06
- Stop
- 2020-12-06
The parties
- Patient
- patient Adolfo Clifford Okuneva
- Provider
- provider Bennie O'Keefe
- Payer
- payer Medicaid
Record id
117319ae-7a08-ce49-c200-2fa709da83a7