Claim total
$949.77
base $127.17 · payer covered $847.37
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2022-09-17
- Stop
- 2022-09-17
The parties
- Patient
- patient Aubrey Sal Champlin
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
1bcbe4dd-bbdd-c343-f092-ebbd22c49277