Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2020-10-03
- Stop
- 2020-10-04
The parties
- Patient
- patient Juan Tracy Lesch
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
3b4291c0-adc4-b6fd-52d0-ce7e37b6671e