Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2016-09-21
- Stop
- 2016-09-21
The parties
- Patient
- patient Luisa Sonia Luna
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Anthem
Record id
379f6bfe-9300-93d1-7d95-2a23defd5617