Claim total
$4,854.63
base $127.17 · payer covered $4,819.63
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2023-02-12
- Stop
- 2023-02-12
The parties
- Patient
- patient Erich Leffler
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Dual Eligible
Record id
2b764b05-4e2e-e4ab-2ee9-c0809a7c2cb4