Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2019-04-29
- Stop
- 2019-04-29
The parties
- Patient
- patient Elana Mandie Wiegand
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Aetna
Record id
30743a72-2cf0-d9e1-5d11-5c60fd9c276b