Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2019-11-11
- Stop
- 2019-11-11
The parties
- Patient
- patient Armand Jonas Braun
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Humana
Record id
13212a7b-a7ba-4ded-b051-a66ba5cd5f8e