Claim total
$949.77
base $127.17 · payer covered $759.82
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2024-10-18
- Stop
- 2024-10-18
The parties
- Patient
- patient Shelton Martin Homenick
- Provider
- provider Elisabeth Smith
- Payer
- payer Medicare
Record id
0febc937-b8c3-3b2e-f9f0-ed24a6dde9f3