Claim total
$4,163.89
base $127.17 · payer covered $4,113.89
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2025-05-01
- Stop
- 2025-05-01
The parties
- Patient
- patient Christiana Refugia Doyle
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
27696c2f-fdde-aea2-0b73-37f6fab0d8ea