Claim total
$12,597.43
base $127.17 · payer covered $12,562.43
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2019-01-08
- Stop
- 2019-01-08
The parties
- Patient
- patient Rosalind Gertude Olson
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Dual Eligible
Record id
30209f9b-1d78-f7a0-bfa7-929ea1a1a193