Claim total
$127.17
base $127.17 · payer covered $83.52
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2020-08-16
- Stop
- 2020-08-16
The parties
- Patient
- patient Lupe Isaiah Goyette
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicare
Record id
0a09c8b4-1b33-f971-f716-f187ce5f497e