Claim total
$949.77
base $127.17 · payer covered $899.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2017-01-20
- Stop
- 2017-01-20
The parties
- Patient
- patient Brooke Ching Towne
- Provider
- provider Marquerite Swaniawski
- Payer
- payer Medicaid
Record id
2dae7153-b96b-01ba-33fc-430f6894ede0