Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2019-08-17
- Stop
- 2019-08-17
The parties
- Patient
- patient Lea Edwina Hand
- Provider
- provider Marquerite Swaniawski
- Payer
- payer Medicaid
Record id
1a0b0fe5-5cd2-3c13-43d9-dddae78e9d8c