Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2018-04-10
- Stop
- 2018-04-10
The parties
- Patient
- patient Clay Brandon Schuppe
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
3310e903-3aa7-ca72-e280-b9f6ef22f33c