Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 1996-06-05
- Stop
- 1996-06-05
The parties
- Patient
- patient Irvin Anibal Jenkins
- Provider
- provider Bennie O'Keefe
- Payer
- payer Medicaid
Record id
0a444a8e-d682-af54-54f9-9d13bebc4342