Claim total
$127.17
base $127.17 · payer covered $92.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 1995-11-13
- Stop
- 1995-11-13
The parties
- Patient
- patient Eloy Mosciski
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Dual Eligible
Record id
22bf68a7-fc86-adb6-54c4-f82987e0369d