Claim total
$3,935.75
base $127.17 · payer covered $3,935.75
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2017-03-24
- Stop
- 2017-03-24
The parties
- Patient
- patient Edythe Nga Pacocha
- Provider
- provider Elisabeth Smith
Record id
00cb11fd-f3f7-0950-d441-7423393bfc08