Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2019-08-24
- Stop
- 2019-08-24
The parties
- Patient
- patient Dusty Tyson Heidenreich
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
2cd4188f-31dd-c72f-6efa-3d0c600c39d0