Claim total
$949.77
base $127.17 · payer covered $899.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2020-01-13
- Stop
- 2020-01-13
The parties
- Patient
- patient Sammy Jessie Maggio
- Provider
- provider Marquerite Swaniawski
- Payer
- payer Medicaid
Record id
38f90e20-b01b-4895-a4d2-64e3c5d76a9f