Claim total
$3,935.75
base $127.17 · payer covered $3,833.35
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2021-04-27
- Stop
- 2021-04-27
The parties
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
2388187a-155e-474a-c555-1a42d69077dc