Claim total
$538.47
base $127.17 · payer covered $488.47
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of knee125601008
- Start
- 2016-11-29
- Stop
- 2016-11-29
The parties
- Patient
- patient Abe Adolph Berge
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicaid
Record id
035310e6-92e0-05c1-56e9-c748e5b418d9