Claim total
$15,977.78
base $127.17 · payer covered $15,927.78
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2023-05-07
- Stop
- 2023-05-07
The parties
- Patient
- patient Matt Stanton Brown
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Medicaid
Record id
04e52287-fbd6-ff57-6e60-bc9fc307b949