Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2008-09-15
- Stop
- 2008-09-15
The parties
- Patient
- patient Camellia Verline Friesen
- Provider
- provider Sheree Kreiger
- Care site
- care site MARANATHA CARE CENTER
- Payer
- payer Medicaid
Record id
0a9c087f-b49c-4185-91c6-650625459902