Claim total
$4,854.63
base $127.17 · payer covered $3,883.71
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2025-09-22
- Stop
- 2025-09-23
The parties
- Patient
- patient Lennie Dannette Jerde
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicare
Record id
14e0014e-0650-d844-2cb8-bf8e9f6b7564