Claim total
$4,854.63
base $127.17 · payer covered $4,819.63
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2015-12-27
- Stop
- 2015-12-27
The parties
- Patient
- patient Benito Beau Keebler
- Provider
- provider Sharen Morar
- Payer
- payer Dual Eligible
Record id
21f14afd-a65c-85c6-e2f4-df159a404ec8