Claim total
$949.77
base $127.17 · payer covered $899.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2017-01-30
- Stop
- 2017-01-30
The parties
- Patient
- patient Domitila Abshire
- Provider
- provider Allan Rowe
- Payer
- payer Medicaid
Record id
2b74c937-4bd9-de09-662a-9d4418fa7724