Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 1986-04-30
- Stop
- 1986-04-30
The parties
- Patient
- patient Mauro Long Emmerich
- Provider
- provider Elisabeth Smith
- Payer
- payer Medicaid
Record id
23076cc7-987a-7400-a63a-b086552dbea0