Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2018-03-18
- Stop
- 2018-03-18
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-dcb9-6afea54b903d