Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2025-04-24
- Stop
- 2025-04-24
The parties
- Patient
- patient Felicita Tamatha Olson
- Provider
- provider Elisabeth Smith
- Payer
- payer Humana
Record id
1163dae7-aced-cce5-774b-3f7ec780a6ff