Claim total
$9,132.24
base $127.17 · payer covered $8,983.07
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2019-07-31
- Stop
- 2019-07-31
The parties
- Patient
- patient Evangeline Kasha Schaden
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicaid
Record id
0632026e-bab4-0d77-8b90-6bbd2934c41d