Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Concussion injury of brain110030002
- Start
- 2016-11-20
- Stop
- 2016-11-21
The parties
- Patient
- patient Laila Suzanne Bruen
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer No insurance
Record id
0f2fce98-e3b7-6178-80a0-121da50a5710