Claim total
$127.17
base $127.17 · payer covered $92.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2022-09-04
- Stop
- 2022-09-04
The parties
- Patient
- patient Suzi Sydney Robel
- Provider
- provider Marquerite Swaniawski
- Payer
- payer Dual Eligible
Record id
0804c552-c9d6-65d3-be57-2a1be5d0ac61