Claim total
$4,854.63
base $127.17 · payer covered $2,912.78
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2011-06-14
- Stop
- 2011-06-14
The parties
- Patient
- patient Daniele Caryl Stracke
- Provider
- provider Britt Borer
- Care site
- care site OUR LADY OF PEACE HOSPICE
- Payer
- payer Humana
Record id
1727d1fa-71e1-4195-12c6-5efb17d711b0