Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2000-12-12
- Stop
- 2000-12-13
The parties
- Patient
- patient Clara Vivien Hackett
- Provider
- provider Claudia Bauch
- Care site
- care site THE VILLA AT ST LOUIS PARK
- Payer
- payer Medicaid
Record id
3396e9b6-2bac-15f6-728d-dbe25c62e90c