Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2018-01-13
- Stop
- 2018-01-13
The parties
- Patient
- patient Audrey Adena Walsh
- Provider
- provider Elisabeth Smith
- Payer
- payer Medicaid
Record id
36bf4dfd-2a30-ae3e-6262-57708356e0a6