Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2017-05-19
- Stop
- 2017-05-19
The parties
- Patient
- patient Lorena Marilu Paredes
- Provider
- provider Britt Borer
- Care site
- care site OUR LADY OF PEACE HOSPICE
- Payer
- payer Medicaid
Record id
0a28d644-c9bb-51b3-974b-d4a989f08acc