Claim total
$4,854.63
base $127.17 · payer covered $4,819.63
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2021-09-30
- Stop
- 2021-09-30
The parties
- Patient
- patient Lucia Eloisa Prado
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Dual Eligible
Record id
130f657d-55b9-f148-2bdd-a974e6cd0179