Claim total
$12,778.81
base $127.17 · payer covered $5,795.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- —
- Start
- 1998-11-23
- Stop
- 1998-11-23
The parties
- Patient
- patient Earle Kenneth Kilback
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
Record id
237ec528-3e88-a814-dcbf-1768b55527d1