Claim total
$1,183.80
base $127.17 · payer covered $763.09
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Acute allergic reaction241929008
- Start
- 2018-09-08
- Stop
- 2018-09-08
The parties
- Patient
- patient Pok Shane Strosin
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicare
Record id
00162663-d9d1-4955-8ade-9d062f2b919a