Claim total
$949.77
base $127.17 · payer covered $899.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2019-09-26
- Stop
- 2019-09-26
The parties
- Patient
- patient Alpha Fahey
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
0d312bb0-9f0e-a43d-e9c8-32332054a74b