Claim total
$949.77
base $127.17 · payer covered $899.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2010-07-08
- Stop
- 2010-07-09
The parties
- Patient
- patient Salome Kanisha D'Amore
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
204f81a9-88e4-4fbf-b715-a037957259aa