Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2023-12-18
- Stop
- 2023-12-18
The parties
- Patient
- patient Jere Henry Senger
- Provider
- provider Davida Wolff
- Payer
- payer Medicaid
Record id
17151df5-5c5f-0774-874c-856904d10934