Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Fracture of ankle16114001
- Start
- 2016-12-22
- Stop
- 2016-12-22
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-0341-0ef60b12695e