Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2023-04-26
- Stop
- 2023-04-26
The parties
- Patient
- patient Niesha Versie Medhurst
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicare
Record id
368e2682-1863-e9f9-7c3d-3805dcf01b98