Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2013-06-10
- Stop
- 2013-06-10
The parties
- Patient
- patient Columbus Kerluke
- Provider
- provider Reginald Bruen
- Payer
- payer Medicaid
Record id
38f2e58f-5d08-f8a7-3e6a-9e6cc6678243