Claim total
$9,217.42
base $127.17 · payer covered $2,433.88
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Impacted molars196416002
- Start
- 2022-02-05
- Stop
- 2022-02-05
The parties
- Patient
- patient Allen Trent Mann
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Humana
Record id
007bcc47-8ca5-7eab-a72d-5a8034257abd