Claim total
$4,213.73
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2020-11-12
- Stop
- 2020-11-12
The parties
- Patient
- patient Marvin Freddie Fisher
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Aetna
Record id
2fabcc2d-ad4a-b3ba-742b-97397b481362