Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2017-09-05
- Stop
- 2017-09-05
The parties
- Patient
- patient Fritz Vance Strosin
- Provider
- provider Elisabeth Smith
- Payer
- payer Medicaid
Record id
3195c6a0-1297-a622-53a5-700c13d961ca