Claim total
$8,003.23
base $127.17 · payer covered $1,292.53
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2017-11-17
- Stop
- 2017-11-17
The parties
- Patient
- patient Estrella Roberts
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Aetna
Record id
0d52cfe9-7506-88f4-ad1b-3811139d8ce6