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
- 2022-08-05
- Stop
- 2022-08-05
The parties
- Patient
- patient Ka Jacobson
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
255c6acb-9d44-0232-cf04-1c8e35afdfde