Claim total
$5,020.36
base $127.17 · payer covered $482.57
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2020-05-09
- Stop
- 2020-05-09
The parties
- Patient
- patient Onie Shannon Borer
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Cigna Health
Record id
006af299-d813-2b4f-59ac-b6a61dfea327