Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2026-06-19
- Stop
- 2026-06-19
The parties
- Patient
- patient Norbert Mitch Rolfson
- Provider
- provider Grant Miller
- Care site
- care site OUR LADY OF PEACE HOME CARE
- Payer
- payer Medicare
Record id
0e9a274f-7ba6-2bd1-3d48-8d5bf94f7a70