Claim total
$949.77
base $127.17 · payer covered $899.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2023-12-03
- Stop
- 2023-12-03
The parties
- Patient
- patient Sylvie Loma Bailey
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicaid
Record id
10d68dd4-2444-6d0f-857e-53f32de39cb5