Claim total
$949.77
base $127.17 · payer covered $899.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2002-09-15
- Stop
- 2002-09-15
The parties
- Patient
- patient Clarine Reanna Hammes
- Provider
- provider Rashad Wilderman
- Care site
- care site EVERYTIME HOME CARE
- Payer
- payer Medicaid
Record id
2de4dd0d-f665-8a2e-3111-561e5115407f