Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2019-02-26
- Stop
- 2019-02-26
The parties
- Patient
- patient Theodore Emory Parisian
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Anthem
Record id
13bbd9ac-5c42-f173-c7eb-89f531f0c921