Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2019-01-29
- Stop
- 2019-01-29
The parties
- Patient
- patient Delmer Maynard Kris
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicare
Record id
0b575b03-961f-f971-7432-ef461db19aa7