Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2017-01-12
- Stop
- 2017-01-12
The parties
- Patient
- patient Vince Jude Tremblay
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Humana
Record id
0f00a4c3-f6b5-b50e-f2a7-509f755c1c1c