Claim total
$127.17
base $127.17 · payer covered $24.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2018-10-29
- Stop
- 2018-10-29
The parties
- Patient
- patient Noel Hodkiewicz
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicaid
Record id
104902ff-0783-21f8-ff7a-c81555120088