Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2024-10-12
- Stop
- 2024-10-12
The parties
- Patient
- patient Carlyn Donita Ortiz
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer No insurance
Record id
00e3929f-91f8-0715-49a3-20b3f27f5dcc