Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2017-07-13
- Stop
- 2017-07-13
The parties
- Patient
- patient Florence Aurora Stokes
- Provider
- provider Davida Wolff
- Payer
- payer Medicare
Record id
16e25379-7680-75f4-4bf2-e4947707a16e