Claim total
$4,854.63
base $127.17 · payer covered $3,853.47
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2008-10-15
- Stop
- 2008-10-15
The parties
- Patient
- patient Jamal Barry Funk
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicare
Record id
19b3aec3-eaf6-e809-da67-6f58d21a24f5