Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2010-09-20
- Stop
- 2010-09-20
The parties
- Patient
- patient Velvet Elease Walter
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Humana
Record id
06af16c1-6409-09e5-2ec0-31ac013fe344