Claim total
$127.17
base $127.17 · payer covered $92.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2024-07-29
- Stop
- 2024-07-29
The parties
- Patient
- patient Gregorio Emory Zieme
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Dual Eligible
Record id
08c7e7ec-1b6d-3f07-ced7-a0d4df6845e3