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
- 2022-09-29
- Stop
- 2022-09-29
The parties
- Patient
- patient Edgar Herzog
- Provider
- provider Grant Miller
- Care site
- care site OUR LADY OF PEACE HOME CARE
- Payer
- payer Dual Eligible
Record id
1f5e460e-a26c-0249-c509-1f4cc72bbe88