Claim total
$12,209.49
base $127.17 · payer covered $12,159.49
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Seizure disorder128613002
- Start
- 1962-11-19
- Stop
- 1962-11-19
The parties
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Medicaid
Record id
02b0534d-1cdc-7379-e25e-2e9030f7c053