Claim total
$949.77
base $127.17 · payer covered $899.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2017-06-26
- Stop
- 2017-06-26
The parties
- Patient
- patient Nickie Armstrong
- Provider
- provider Marquerite Swaniawski
- Payer
- payer Medicaid
Record id
216dff76-8461-8cb6-22c8-26e041bcc1c8