Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2016-09-22
- Stop
- 2016-09-22
The parties
- Patient
- patient Corliss Stormy Shanahan
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
13199f1b-9a57-6e58-be4d-28e8e60eb9cd