Claim total
$12,076.87
base $127.17 · payer covered $12,026.87
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2017-03-13
- Stop
- 2017-03-13
The parties
- Patient
- patient Graham Spinka
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
33610154-42f1-68a4-a9ac-be6f6dcbadd2