Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2020-08-26
- Stop
- 2020-08-26
The parties
- Provider
- provider Britt Borer
- Care site
- care site OUR LADY OF PEACE HOSPICE
- Payer
- payer UnitedHealthcare
Record id
0177a0d4-f7b6-3393-5b5c-7c2c8912f7ad