Claim total
$538.47
base $127.17 · payer covered $488.47
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of knee125601008
- Start
- 2025-03-24
- Stop
- 2025-03-24
The parties
- Patient
- patient Kory Davis
- Provider
- provider Elisabeth Smith
- Payer
- payer Medicaid
Record id
27dbccbd-09c2-ffea-87c4-1cef1e8071a6