Claim total
$949.77
base $127.17 · payer covered $759.82
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2015-09-11
- Stop
- 2015-09-11
The parties
- Patient
- patient Jody Shoshana Powlowski
- Provider
- provider Sheree Kreiger
- Care site
- care site MARANATHA CARE CENTER
- Payer
- payer Medicare
Record id
226e0527-4c40-2548-7f24-aa42d99d5bd0