Claim total
$127.17
base $127.17 · payer covered $69.82
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2017-01-23
- Stop
- 2017-01-23
The parties
- Patient
- patient Craig Kurt Orn
- Provider
- provider Elisabeth Smith
- Payer
- payer Medicaid
Record id
095b4f34-2320-d468-f2b5-17ae26d1d9a4