Claim total
$7,161.11
base $127.17 · payer covered $5,728.89
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2025-06-20
- Stop
- 2025-06-20
The parties
- Patient
- patient Emma Daphne Gusikowski
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicare
Record id
135051de-1be9-22ef-252f-551230df3d43