Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2005-10-10
- Stop
- 2005-10-11
The parties
- Patient
- patient María Micaela Magaña
- Provider
- provider Elisabeth Smith
- Payer
- payer Medicaid
Record id
0b835039-e875-4ecd-f5f8-bbce0bc61889