Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2016-11-16
- Stop
- 2016-11-16
The parties
- Patient
- patient Clara O'Conner
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Aetna
Record id
0f6ac757-f138-648f-27d9-b55b87ef2b3c