Claim total
$4,854.63
base $127.17 · payer covered $3,883.71
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2007-07-04
- Stop
- 2007-07-04
The parties
- Patient
- patient Vance Nick Hudson
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicare
Record id
2d31b05f-e99a-3ac8-cf24-b38c68070381