Claim total
$15,361.54
base $127.17 · payer covered $15,311.54
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2026-07-14
- Stop
- 2026-07-14
The parties
- Patient
- patient Gala Marcelene Hirthe
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicaid
Record id
220f299b-95df-592e-a25c-87b43fcc30d5