Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2018-06-25
- Stop
- 2018-06-25
The parties
- Patient
- patient Ferne Nickie Bauch
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
31438dc9-02e7-e2ef-6674-59e8baf8ce2d