Claim total
$4,085.28
base $127.17 · payer covered $4,035.28
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2019-12-03
- Stop
- 2019-12-03
The parties
- Patient
- patient Rodger Leonardo Padberg
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Medicaid
Record id
2beb7299-0f83-f346-72a9-73dfa1c74289