Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 1986-10-13
- Stop
- 1986-10-13
The parties
- Patient
- patient Azalee Lura Koepp
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer No insurance
Record id
20852a5c-dbef-c661-295e-c0971a988423