Claim total
$15,011.94
base $127.17 · payer covered $14,961.94
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2025-06-20
- Stop
- 2025-06-20
The parties
- Patient
- patient Hertha Conception Von
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Medicaid
Record id
0d4ddbb6-9f39-9726-679d-0e4ca8813ef4