Claim total
$127.17
base $127.17 · payer covered $40.67
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2010-06-26
- Stop
- 2010-06-26
The parties
- Patient
- patient Solomon Amado Purdy
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Medicaid
Record id
1e6fa6a9-1f41-5355-f0a0-32b296c2401b