Claim total
$949.77
base $127.17 · payer covered $847.37
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2020-07-29
- Stop
- 2020-07-29
The parties
- Patient
- patient Mary Teodoro Rutherford
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
250f5ef4-c14c-ed2f-5f68-225360846069