Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2004-07-10
- Stop
- 2004-07-10
The parties
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
1b4b3772-3827-eee9-7a58-cdbdeefd1351