Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2023-10-09
- Stop
- 2023-10-10
The parties
- Patient
- patient Tuan Jarred Volkman
- Provider
- provider Elisabeth Smith
- Payer
- payer Medicaid
Record id
148a1791-9b8b-0048-6b25-e10243030157