Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2020-10-15
- Stop
- 2020-10-15
The parties
- Patient
- patient Vernita Lona Prosacco
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Medicaid
Record id
08fb9d8b-52e7-8882-aa89-f0024d85230e