Claim total
$5,726.81
base $127.17 · payer covered $5,676.81
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2020-04-20
- Stop
- 2020-04-20
The parties
- Patient
- patient Berta Gertrudis Cummings
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicaid
Record id
1009e049-d13f-b014-645e-56157ab19068