Claim total
$4,077.37
base $127.17 · payer covered $3,261.90
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2017-07-28
- Stop
- 2017-07-28
The parties
- Patient
- patient Rufus Milford Koelpin
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicare
Record id
3a95383e-dcb8-456a-cfc7-b6e281fed48b