Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2023-07-12
- Stop
- 2023-07-12
The parties
- Patient
- patient Richie Michael Mante
- Provider
- provider Bennie O'Keefe
- Payer
- payer No insurance
Record id
12bd5fca-647b-3667-ae01-1ceecf745371