Claim total
$127.17
base $127.17 · payer covered $92.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2018-12-21
- Stop
- 2018-12-21
The parties
- Patient
- patient Aaron Merle Schroeder
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Dual Eligible
Record id
347e8a4e-5c81-360d-ba45-07f76e5616ad