Claim total
$4,854.63
base $127.17 · payer covered $521.54
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2021-04-23
- Stop
- 2021-04-23
The parties
- Patient
- patient Ross Bill Bradtke
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Cigna Health
Record id
2a675be2-5a92-6634-2fb4-0abc3247b15f