Claim total
$127.17
base $127.17 · payer covered $17.99
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2021-04-28
- Stop
- 2021-04-28
The parties
- Patient
- patient Luis Feest
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Humana
Record id
220781f0-a6c5-bfd4-555e-a4fe87558ddc