Claim total
$538.47
base $127.17 · payer covered $430.78
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of knee125601008
- Start
- 2021-12-26
- Stop
- 2021-12-26
The parties
- Patient
- patient Antonia Palacios
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Anthem
Record id
3695eacd-d76f-1a40-63ab-f8e1d45d3240