Claim total
$14,347.79
base $127.17 · payer covered $7,544.35
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2024-03-23
- Stop
- 2024-03-23
The parties
- Patient
- patient Theresia Kylie Ferry
- Provider
- provider Elisabeth Smith
- Payer
- payer Aetna
Record id
20b286d8-4a17-89cc-300e-257b94b48b51