Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2018-07-04
- Stop
- 2018-07-04
The parties
- Patient
- patient Chung Spinka
- Provider
- provider Allan Rowe
- Payer
- payer Medicare
Record id
0453bbfc-4b53-3293-96e9-04191013f67a