Claim total
$4,854.63
base $127.17 · payer covered $3,883.71
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 1997-10-30
- Stop
- 1997-10-30
The parties
- Patient
- patient Lucie Shayla Metz
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicare
Record id
0095f26f-6c35-6a9c-87c8-555fab06478d