Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2021-09-05
- Stop
- 2021-09-05
The parties
- Patient
- patient Roger Brain Homenick
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
289be5b0-48cc-7d34-c4c4-ff437fbabf99