Claim total
$866.00
base $127.17 · payer covered $692.80
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- —
- Start
- 2011-06-12
- Stop
- 2011-06-12
The parties
- Patient
- patient Lesia Catalina Ledner
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicare
Record id
058279b6-7701-4823-897b-aa67f2f519d4