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
- 2019-09-27
- Stop
- 2019-09-27
The parties
- Patient
- patient Terry Deshawn Abernathy
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Aetna
Record id
150667cd-c021-fe37-00be-ad0a22e8e84a