Claim total
$10,234.27
base $127.17 · payer covered $10,184.27
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2017-06-22
- Stop
- 2017-06-22
The parties
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
10a4f5a3-ff3e-0b69-e0d1-acf3063a4be7