Claim total
$127.17
base $127.17 · payer covered $41.93
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2023-11-11
- Stop
- 2023-11-11
The parties
- Provider
- provider Britt Borer
- Care site
- care site OUR LADY OF PEACE HOSPICE
- Payer
- payer Medicaid
Record id
3277839e-f34a-a663-5cab-b4492a5ed394