Claim total
$949.77
base $127.17 · payer covered $759.82
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2002-11-22
- Stop
- 2002-11-22
The parties
- Patient
- patient Aurora Desire Raynor
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicare
Record id
124b3f89-9575-2f99-a849-7a9d70df11bb