Claim total
$4,854.63
base $127.17 · payer covered $4,804.63
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2009-09-20
- Stop
- 2009-09-20
The parties
- Patient
- patient Irvin Anibal Jenkins
- Provider
- provider Bennie O'Keefe
- Payer
- payer Medicaid
Record id
0a444a8e-d682-af54-7443-89b586b6a1f3