Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2022-05-09
- Stop
- 2022-05-09
The parties
- Patient
- patient Raquel Mimi Maggio
- Provider
- provider Davida Wolff
- Payer
- payer UnitedHealthcare
Record id
37f675b1-f539-0d89-c037-01cee74903a5