Claim total
$15,361.54
base $127.17 · payer covered $15,311.54
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2024-10-25
- Stop
- 2024-10-25
The parties
- Patient
- patient Anisha Harber
- Provider
- provider Elisabeth Smith
- Payer
- payer Medicaid
Record id
3a07fb89-0020-0893-e19e-41d85b03f44b