Claim total
$10,636.71
base $127.17 · payer covered $3,601.61
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2019-08-29
- Stop
- 2019-08-29
The parties
- Patient
- patient Leo Ramon Wolf
- Provider
- provider Davida Wolff
- Payer
- payer Aetna
Record id
0132d8d5-6e6e-d90f-b30d-39f95f6497dc