Claim total
$14,972.20
base $127.17 · payer covered $11,869.44
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2026-09-07
- Stop
- 2026-09-08
The parties
- Patient
- patient Trevor Darrick Legros
- Provider
- provider Davida Wolff
- Payer
- payer Medicare
Record id
216fad95-7533-5170-71cc-128cf3dee3f4