Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2026-03-22
- Stop
- 2026-03-22
The parties
- Patient
- patient Jesse Lucas Rowe
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
16996bed-1187-99fd-d4a7-d43a00d23bde