Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 1972-11-03
- Stop
- 1972-11-04
The parties
- Patient
- patient Quinn Maximo Hartmann
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicare
Record id
262dbc34-d670-c004-3c05-8d8cd9593cc6