Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2008-06-22
- Stop
- 2008-06-23
The parties
- Patient
- patient Sammy Denis Dooley
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
36a2d409-ef1c-3246-2663-cb63b9662853