Claim total
$133.26
base $127.17 · payer covered $83.26
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- —
- Start
- 2020-03-30
- Stop
- 2020-03-30
The parties
- Patient
- patient Elliot Blaine Buckridge
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicaid
Record id
00a5a31e-a2f8-175f-9fb7-d9562d41da67