Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2018-12-15
- Stop
- 2018-12-15
The parties
- Patient
- patient Le Rosella Marks
- Provider
- provider Bennie O'Keefe
- Payer
- payer Medicaid
Record id
08d0bbfe-3183-9cfc-3898-d217d12405f5