Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2018-05-16
- Stop
- 2018-05-16
The parties
- Patient
- patient Elbert Hyman Swaniawski
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
Record id
37096919-2ce6-bbeb-12d9-a427c4a80559