Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2026-01-06
- Stop
- 2026-01-06
The parties
- Patient
- patient Kandice Marks
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicaid
Record id
1491eba8-6778-81ff-7146-eeb78ec3d8cc