Claim total
$949.77
base $127.17 · payer covered $382.28
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2021-12-30
- Stop
- 2022-01-07
The parties
- Patient
- patient Many Allison Thiel
- Provider
- provider Elisabeth Smith
- Payer
- payer Anthem
Record id
1c4efcbe-1cf5-b1b9-f9c9-a32fa44b430e