Claim total
$12,792.50
base $127.17 · payer covered $12,742.50
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- —
- Start
- 1996-03-01
- Stop
- 1996-03-01
The parties
- Patient
- patient Pamula Ellan Kiehn
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
3a501eb2-e422-6d85-4a16-83353e1235d3