Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2017-03-11
- Stop
- 2017-03-11
The parties
- Patient
- patient Leeanna Carylon Fadel
- Provider
- provider Davida Wolff
- Payer
- payer Anthem
Record id
2ada2143-53df-130a-2fd0-1cfd7b2c3f47