Claim total
$127.17
base $127.17 · payer covered $29.22
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2022-10-14
- Stop
- 2022-10-14
The parties
- Patient
- patient Chantell Portia Daniel
- Provider
- provider Elisabeth Smith
- Payer
- payer Medicaid
Record id
194e887f-bbea-2bd4-2b5b-f8b246e6cd8e