Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 1995-07-21
- Stop
- 1995-07-21
The parties
- Patient
- patient Danielle Frami
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
0eed755f-204b-92be-fa70-4110f96686f8