Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2010-04-29
- Stop
- 2010-04-29
The parties
- Patient
- patient Latia Edna Ullrich
- Provider
- provider Evalyn Torphy
- Care site
- care site ALLIANCE HHC & NURSING SERVICE
- Payer
- payer Medicaid
Record id
366476ce-6427-c6cf-c74d-3c07623a3f89