Claim total
$949.77
base $127.17 · payer covered $914.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2018-08-31
- Stop
- 2018-08-31
The parties
- Patient
- patient Chester Max Schaden
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Dual Eligible
Record id
38643954-fade-a0d0-319f-b987e029bdcf