Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2019-01-17
- Stop
- 2019-01-17
The parties
- Patient
- patient Aracely Dach
- Provider
- provider Reginald Bruen
- Payer
- payer Medicaid
Record id
1a6a6539-4801-ed9e-1b66-39de7e969f96