Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2016-06-14
- Stop
- 2016-06-14
The parties
- Patient
- patient Lanelle Valrie Barton
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
2d0d3531-8acb-0cb2-2a09-0980f5c17c56