Claim total
$3,935.75
base $127.17 · payer covered $3,885.75
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2025-04-19
- Stop
- 2025-04-19
The parties
- Patient
- patient Bernard Chance Dach
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
1c7e8426-4002-fe7b-e1a1-a240f358d59c