Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2021-06-03
- Stop
- 2021-06-03
The parties
- Patient
- patient Eddy Brain Padberg
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Humana
Record id
06fbd395-4cad-21bc-c69e-2b3346347a91