Claim total
$538.47
base $127.17 · payer covered $488.47
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of knee125601008
- Start
- 2018-08-15
- Stop
- 2018-08-15
The parties
- Patient
- patient Tamra Darlena Feeney
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
39f891f2-42e3-2507-7cf6-1c121710ec75