Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2025-05-24
- Stop
- 2025-05-24
The parties
- Patient
- patient Jackeline Becker
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Humana
Record id
0ac63550-d2bd-cff8-acd8-1d6817938747