Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2019-07-03
- Stop
- 2019-07-03
The parties
- Patient
- patient Bell Casper
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicaid
Record id
2363ad65-7b0d-dffb-67e1-ea63096a5947