Claim total
$6,963.68
base $127.17 · payer covered $6,928.68
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2024-10-22
- Stop
- 2024-10-22
The parties
- Patient
- patient Adrian Micha Kerluke
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Dual Eligible
Record id
2b9ed8b6-8e66-2dd9-268d-b95a5a1fa2cd