Claim total
$3,935.75
base $127.17 · payer covered $3,885.75
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2020-02-05
- Stop
- 2020-02-05
The parties
- Patient
- patient Thu Sunni Funk
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
32486fb2-66f7-813c-1255-84b260bede1c