Claim total
$127.17
base $127.17 · payer covered $92.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 1990-10-29
- Stop
- 1990-10-30
The parties
- Patient
- patient Mauro Long Emmerich
- Provider
- provider Elisabeth Smith
- Payer
- payer Dual Eligible
Record id
23076cc7-987a-7400-85f1-34e9f25dc42c