Claim total
$4,185.69
base $127.17 · payer covered $4,135.69
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2016-08-07
- Stop
- 2016-08-07
The parties
- Patient
- patient Milly Susanne Blick
- Provider
- provider Elisabeth Smith
- Payer
- payer Medicaid
Record id
31251599-7078-e241-b6ac-b6d5dd90332a