Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 1998-11-18
- Stop
- 1998-11-19
The parties
- Patient
- patient Isaac Roberto Goyette
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
29b08593-21af-d81d-a9b5-d577ead6b3b4