Claim total
$3,668.70
base $127.17 · payer covered $3,618.70
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2020-11-18
- Stop
- 2020-11-18
The parties
- Patient
- patient Berta María José Anaya
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicaid
Record id
1c7e06b6-7da5-69dd-04f7-883ba8e9cdb6