Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2019-09-17
- Stop
- 2019-09-17
The parties
- Patient
- patient Jefferson Renaldo Dach
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer UnitedHealthcare
Record id
17cb5ccc-4c1f-9747-be66-ad1145730ddb