Claim total
$949.77
base $127.17 · payer covered $759.82
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2022-05-17
- Stop
- 2022-05-17
The parties
- Patient
- patient Joan Donnie Quitzon
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicare
Record id
056f2732-3438-a432-6cb8-cf3792960fde