Claim total
$11,079.17
base $127.17 · payer covered $3,108.86
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2024-10-01
- Stop
- 2024-10-01
The parties
- Patient
- patient Laveta Francene Weissnat
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Humana
Record id
240d2fda-d10d-b793-5907-33431cba4027