Claim total
$127.17
base $127.17 · payer covered $92.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2020-11-27
- Stop
- 2020-11-27
The parties
- Patient
- patient Rafael Jacob Stark
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Dual Eligible
Record id
317ac6ea-e6de-31fb-b010-7fc6ef04f272