Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2023-05-17
- Stop
- 2023-05-18
The parties
- Patient
- patient Kylie Alysa Herzog
- Provider
- provider Allan Rowe
- Payer
- payer Medicaid
Record id
097fc80f-e956-12e7-7263-efbb763c1444