Claim total
$949.77
base $127.17 · payer covered $664.84
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2023-12-24
- Stop
- 2023-12-24
The parties
- Patient
- patient Hilton Marcelino Friesen
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Cigna Health
Record id
069d1f4a-1b6f-6d04-af2b-c7d0dc5b115e