Claim total
$1,772.37
base $127.17 · payer covered $407.66
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of mandible263172003
- Start
- 2019-12-31
- Stop
- 2019-12-31
The parties
- Patient
- patient Elizbeth Deedra Boyer
- Provider
- provider Rusty Hegmann
- Care site
- care site BAYADA HOME HEALTH CARE INC
- Payer
- payer Anthem
Record id
33874f57-1c04-26b4-a7cf-147d49656207