Claim total
$949.77
base $127.17 · payer covered $899.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2016-09-30
- Stop
- 2016-09-30
The parties
- Patient
- patient Myrtle Tana Casper
- Provider
- provider Evalyn Torphy
- Care site
- care site ALLIANCE HHC & NURSING SERVICE
- Payer
- payer Medicaid
Record id
2a4c8829-e297-058f-8d88-286c614bdafa