Claim total
$3,935.75
base $127.17 · payer covered $272.21
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2025-12-08
- Stop
- 2025-12-08
The parties
- Patient
- patient Luis Feest
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Humana
Record id
220781f0-a6c5-bfd4-6d2c-16a5c988b9f7