Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2017-12-19
- Stop
- 2017-12-19
The parties
- Patient
- patient Lecia Ivana Jerde
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer UnitedHealthcare
Record id
3301d0d7-3d54-d3c6-eba8-689af3a88ed5