Claim total
$127.17
base $127.17 · payer covered $34.61
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2018-05-16
- Stop
- 2018-05-16
The parties
- Patient
- patient Richie Michael Mante
- Provider
- provider Bennie O'Keefe
- Payer
- payer Medicaid
Record id
12bd5fca-647b-3667-a9c1-46068d883225