Claim total
$15,361.54
base $127.17 · payer covered $15,311.54
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2021-03-28
- Stop
- 2021-03-28
The parties
- Patient
- patient Junior Austin Goldner
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
351313e2-433e-88f5-3641-40b908ab3d9b