Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2024-06-05
- Stop
- 2024-06-05
The parties
- Patient
- patient Brooke Ching Towne
- Provider
- provider Marquerite Swaniawski
- Payer
- payer Medicaid
Record id
2dae7153-b96b-01ba-95e1-e0572987029d