Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2020-04-03
- Stop
- 2020-04-03
The parties
- Patient
- patient Devorah Xiao Zemlak
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Humana
Record id
2bd68ab8-f54b-97f8-a251-9d2db7ad150f