Claim total
$4,854.63
base $127.17 · payer covered $3,883.71
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2022-02-12
- Stop
- 2022-02-12
The parties
- Patient
- patient Libby Hettie Cruickshank
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Medicare
Record id
1a6a8fff-e731-ef09-6a43-f9509145b392