Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2022-08-23
- Stop
- 2022-08-24
The parties
- Patient
- patient Mary Florencio Mayert
- Provider
- provider Emmanuel Champlin
- Care site
- care site CREST VIEW HOME HEALTH CARE
- Payer
- payer Medicaid
Record id
07b62db6-79d4-bb5c-4e80-dfbbaee4448f