Claim total
$127.17
base $127.17 · payer covered $127.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2025-05-21
- Stop
- 2025-05-21
The parties
- Patient
- patient Novella Aleta Bartell
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Aetna
Record id
253a50da-1cc7-1c38-4fa6-0b426d6c3589