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
- 2017-03-29
- Stop
- 2017-03-29
The parties
- Patient
- patient Keith Marquis Ritchie
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
30a39716-1c18-1f3a-bb34-c04b10bf130f