Claim total
$949.77
base $127.17 · payer covered $899.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2018-05-31
- Stop
- 2018-05-31
The parties
- Patient
- patient Lorena Marilu Paredes
- Provider
- provider Britt Borer
- Care site
- care site OUR LADY OF PEACE HOSPICE
- Payer
- payer Medicaid
Record id
0a28d644-c9bb-51b3-dc95-e5211945f25c