Claim total
$4,122.02
base $127.17 · payer covered $4,072.02
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2021-03-03
- Stop
- 2021-03-03
The parties
- Patient
- patient Gilma Ivy Sporer
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
342f92f5-8a6e-b6a8-3405-306661afdb64