Claim total
$13,144.93
base $127.17 · payer covered $10,515.95
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2023-12-04
- Stop
- 2023-12-04
The parties
- Patient
- patient Shane Ulysses Corwin
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Medicare
Record id
10fe28ac-fc4b-0361-9633-189185b6ba20