Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2017-03-20
- Stop
- 2017-03-20
The parties
- Patient
- patient Felipe José Luis Terán
- Provider
- provider Marquerite Swaniawski
- Payer
- payer Medicaid
Record id
39c6f202-28cd-e2b5-c99d-5d740b8619ce