Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2025-02-05
- Stop
- 2025-02-05
The parties
- Patient
- patient Rosanna Alberta Lubowitz
- Provider
- provider Marquerite Swaniawski
- Payer
- payer Anthem
Record id
247f72d2-4061-5a68-a471-948ded2b6a26