Claim total
$949.77
base $127.17 · payer covered $899.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2025-04-30
- Stop
- 2025-04-30
The parties
- Patient
- patient Florentino Crooks
- Provider
- provider Óscar Quiñones
- Care site
- care site IN-HOME LAB CONNECTION INC
- Payer
- payer Medicaid
Record id
0ed645d3-1659-0a65-f06a-3aac16a9939a