Claim total
$127.17
base $127.17 · payer covered $23.86
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2026-07-10
- Stop
- 2026-07-10
The parties
- Patient
- patient Adella Portia Wolf
- Provider
- provider Elisabeth Smith
- Payer
- payer Medicaid
Record id
1aecd3e0-487a-0af8-d1cb-b1643fe2cdd7