Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2020-10-13
- Stop
- 2020-10-13
The parties
- Patient
- patient Nickie Armstrong
- Provider
- provider Marquerite Swaniawski
- Payer
- payer Medicaid
Record id
216dff76-8461-8cb6-bf39-a4e0ae880179