Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2017-06-29
- Stop
- 2017-06-29
The parties
- Patient
- patient Emile Lawerence Lesch
- Provider
- provider Elisabeth Smith
- Payer
- payer Medicaid
Record id
2fda87fd-29fd-b4f1-1a71-ffa232201c91