Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2025-11-04
- Stop
- 2025-11-04
The parties
- Patient
- patient Ruthie Cythia Collins
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Humana
Record id
1d22cf46-63f9-38bb-6ba8-be6f58db50e9