Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2023-04-04
- Stop
- 2023-04-04
The parties
- Patient
- patient Barney Kraig Jast
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicare
Record id
220ee7db-972d-3106-beeb-aab1358d2a0a