Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2014-01-15
- Stop
- 2014-01-15
The parties
- Patient
- patient Lupe Heathcote
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
22929a68-92a8-362b-77cf-f5d34ff11851