Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2017-07-25
- Stop
- 2017-07-25
The parties
- Patient
- patient Randi Donya Lehner
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
Record id
23be53d1-b91c-dce0-b14b-45cd7370877b