Claim total
$17,391.83
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of mandible263172003
- Start
- 2005-12-04
- Stop
- 2005-12-05
The parties
- Patient
- patient Mitsue Sipes
- Provider
- provider Rashad Wilderman
- Care site
- care site EVERYTIME HOME CARE
- Payer
- payer No insurance
Record id
12bc3113-50d7-c8ca-fc29-d798d257c9fd