Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2022-09-12
- Stop
- 2022-09-12
The parties
- Patient
- patient Leilani Melany Kuvalis
- Provider
- provider Marquerite Swaniawski
- Payer
- payer Medicaid
Record id
222da595-6329-b84e-4821-377d80b8ff43