Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2022-10-29
- Stop
- 2022-10-29
The parties
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicare
Record id
31dc5cc7-ca28-5a13-08a7-c9e5b69bc8d8