Claim total
$949.77
base $127.17 · payer covered $899.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2023-08-20
- Stop
- 2023-08-20
The parties
- Patient
- patient Monnie Jesica Cremin
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
06e27cae-eea1-0277-758a-f36c6a504b7d