Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2024-03-03
- Stop
- 2024-03-03
The parties
- Patient
- patient Elias Earl O'Connell
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Medicaid
Record id
321797d2-96a2-8ef1-2a7d-08c4c5f9c2b8