Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2020-09-01
- Stop
- 2020-09-01
The parties
- Patient
- patient Mary Anibal Weissnat
- Provider
- provider Marquerite Swaniawski
- Payer
- payer Medicaid
Record id
2db43a26-232a-1c26-c6a9-2df50838770b