Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 1993-09-01
- Stop
- 1993-09-01
The parties
- Patient
- patient Leilani Melany Kuvalis
- Provider
- provider Marquerite Swaniawski
- Payer
- payer Medicaid
Record id
222da595-6329-b84e-9373-6e634c543f9a