Claim total
$538.47
base $127.17 · payer covered $430.78
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of knee125601008
- Start
- 1994-02-21
- Stop
- 1994-02-21
The parties
- Patient
- patient Mireya Bode
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicare
Record id
04f53306-ad14-544b-f487-44e4260df785