Claim total
$15,361.54
base $127.17 · payer covered $6,221.79
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2008-10-06
- Stop
- 2008-10-06
The parties
- Patient
- patient Blake Cruz Little
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Humana
Record id
1200953b-9706-e442-1d4f-bee7a13ef87d