Claim total
$4,908.21
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- —
- Start
- 2011-05-28
- Stop
- 2011-05-28
The parties
- Patient
- patient Porfirio West
- Provider
- provider Davida Wolff
- Payer
- payer Humana
Record id
05880a71-6004-727f-3446-f932bee60756