Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2020-07-29
- Stop
- 2020-07-29
The parties
- Patient
- patient Sebastian Lavern Brown
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
36deb4e8-cfd4-07d1-ee4e-e4e291c3b85b