Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2025-05-18
- Stop
- 2025-05-19
The parties
- Patient
- patient Arlie Dee Shields
- Provider
- provider Óscar Quiñones
- Care site
- care site IN-HOME LAB CONNECTION INC
- Payer
- payer Medicaid
Record id
25630705-6421-63dd-5a62-7f26e7419aad