Claim total
$7,809.93
base $127.17 · payer covered $7,759.93
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2017-10-07
- Stop
- 2017-10-07
The parties
- Patient
- patient Darin Junior Bechtelar
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicaid
Record id
0c61e84b-1160-ee5c-3399-f8f69eaa4957