Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2025-10-22
- Stop
- 2025-10-22
The parties
- Patient
- patient Evangeline Farrah Bode
- Provider
- provider Sheree Kreiger
- Care site
- care site MARANATHA CARE CENTER
- Payer
- payer Medicaid
Record id
2beddb75-2ebe-b789-8377-1f71ce666b83