Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2022-04-26
- Stop
- 2022-04-26
The parties
- Patient
- patient Boyce Octavio Klocko
- Provider
- provider Sau Wiegand
- Care site
- care site MVNA
- Payer
- payer Humana
Record id
1f95e0d2-c2aa-d203-2e57-68348057f079