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
- 2026-06-22
- Stop
- 2026-06-22
The parties
- Patient
- patient Selene Dona Okuneva
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicare
Record id
1922bd27-5aa8-1926-464c-16e0e0b05300