Claim total
$949.77
base $127.17 · payer covered $759.82
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2014-01-12
- Stop
- 2014-01-12
The parties
- Patient
- patient Yun Herminia Barton
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicare
Record id
100eef27-6b16-ad8b-42e3-349fc377ff12