Claim total
$4,854.63
base $127.17 · payer covered $3,883.71
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 1991-09-11
- Stop
- 1991-09-11
The parties
- Patient
- patient Gale Stokes
- Provider
- provider Ismael Botsford
- Care site
- care site WSCHS, INC - AGAPE CLINIC
- Payer
- payer Medicare
Record id
01a64b50-bd68-5ef7-4c34-a94017a55fef