Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Gunshot wound283545005
- Start
- 1977-02-26
- Stop
- 1977-02-26
The parties
- Patient
- patient Ronnie Ina Gusikowski
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
003b30a0-7fd2-f42c-ae1b-7634d9c30b77