Claim total
$1,977.96
base $127.17 · payer covered $1,582.37
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Acute allergic reaction241929008
- Start
- 2019-12-26
- Stop
- 2019-12-26
The parties
- Patient
- patient Pok Shane Strosin
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicare
Record id
00162663-d9d1-4955-7489-990bbb67d456