Claim total
$949.77
base $127.17 · payer covered $803.46
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2025-04-21
- Stop
- 2025-04-21
The parties
- Patient
- patient Dexter Garland Fahey
- Provider
- provider Sonny Zboncak
- Care site
- care site CREST VIEW LUTHERAN HOME
- Payer
- payer Medicaid
Record id
38f68aff-f470-8bd4-35c8-e49472e3436a