Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2019-08-03
- Stop
- 2019-08-03
The parties
- Patient
- patient Antonia Sherwood Schmitt
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Medicaid
Record id
1888bd1d-48de-7570-c08a-6a47e2927674