Claim total
$7,698.65
base $127.17 · payer covered $7,648.65
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2024-04-23
- Stop
- 2024-04-23
The parties
- Patient
- patient Percy Dwight Hamill
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicaid
Record id
2a6420b9-f515-a0d3-0ed6-4a13922ca09f