Claim total
$3,935.75
base $127.17 · payer covered $3,935.75
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2026-09-05
- Stop
- 2026-09-05
The parties
- Patient
- patient Eileen Nicolette Blanda
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
Record id
1e15063e-b453-6e17-1b67-05616c9b0cdc