Claim total
$3,935.75
base $127.17 · payer covered $3,885.75
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2020-01-12
- Stop
- 2020-01-12
The parties
- Patient
- patient Gerardo Marvin Johns
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Medicaid
Record id
01513b97-46a6-1303-d7bd-91d56f9ecd70