Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2026-01-14
- Stop
- 2026-01-14
The parties
- Patient
- patient Eduardo Hugo Salas
- Provider
- provider Sheree Kreiger
- Care site
- care site MARANATHA CARE CENTER
- Payer
- payer Medicaid
Record id
368bd39f-60e1-6930-1f19-c903dd792ee1