Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2016-10-21
- Stop
- 2016-10-21
The parties
- Patient
- patient Kathern Fisher
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer UnitedHealthcare
Record id
285c751b-3623-4a50-13db-3c9ea1aaa4b1