Claim total
$127.17
base $127.17 · payer covered $92.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 1970-03-30
- Stop
- 1970-03-30
The parties
- Patient
- patient Laverne Neal Brakus
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Dual Eligible
Record id
18f6d2aa-fdf5-2347-c90f-e3b13c66552c