Claim total
$12,371.39
base $127.17 · payer covered $3,957.37
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2019-07-17
- Stop
- 2019-07-17
The parties
- Patient
- patient Boyce Jerrold Johns
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Humana
Record id
18cbb615-420a-8641-303e-68a88d438802