Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2017-04-07
- Stop
- 2017-04-08
The parties
- Patient
- patient Trevor Darrick Legros
- Provider
- provider Davida Wolff
- Payer
- payer Medicare
Record id
216fad95-7533-5170-8fcb-ab490e81d1d2