Claim total
$10,403.62
base $127.17 · payer covered $10,343.61
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 1954-04-12
- Stop
- 1954-04-12
The parties
- Patient
- patient Arthur Pablo Greenfelder
- Provider
- provider Reginald Bruen
- Payer
- payer Medicaid
Record id
028512d5-49bb-87e7-dd67-c00dfb3dfe7b