Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 1996-05-30
- Stop
- 1996-05-31
The parties
- Patient
- patient Scott Emelina Fisher
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
3876b3a4-351a-6d35-2439-3bef5123fb7d