Claim total
$3,935.75
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 1985-07-30
- Stop
- 1985-07-30
The parties
- Patient
- patient Alan Danny White
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Humana
Record id
0d37fa46-9809-7e01-3cd1-a23b6430edaf