Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2018-03-25
- Stop
- 2018-03-25
The parties
- Patient
- patient Everette Gustavo Kunze
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
0fd188c9-40b7-ec3b-00a8-d0b7dc58f048