Claim total
$1,361.07
base $127.17 · payer covered $1,311.07
The visit
- Class
- Emergency
- Code
- 183460006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2017-08-01
- Stop
- 2017-08-01
The parties
- Patient
- patient Peg Tresa Cummerata
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Medicaid
Record id
04fb4e35-41c7-7592-683e-7a200ecb21fa