Claim total
$6,964.39
base $127.17 · payer covered $5,571.52
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2019-06-22
- Stop
- 2019-06-22
The parties
- Patient
- patient Allan Ivan Kuphal
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicare
Record id
2cc14d47-c00d-f33b-a789-49ea67f7d4d9