Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2018-11-14
- Stop
- 2018-11-14
The parties
- Patient
- patient Gus Calvin Schuppe
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
199845c3-149e-96db-079a-2de00488ba78