Claim total
$12,694.11
base $127.17 · payer covered $10,155.29
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2021-11-08
- Stop
- 2021-11-08
The parties
- Patient
- patient Blanche Bernier
- Provider
- provider Concepción Baeza
- Care site
- care site GOOD SAMARITAN AMBASSADOR
- Payer
- payer Medicare
Record id
2c01101e-9e7a-a6ae-cf4f-1ac71482936a