Claim total
$127.17
base $127.17 · payer covered $92.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2019-04-24
- Stop
- 2019-04-24
The parties
- Patient
- patient Freddie Eneida Johnston
- Provider
- provider Niesha Walter
- Payer
- payer Dual Eligible
Record id
266dd9ea-09f0-0693-9483-dd6551c4b066