Claim total
$8,162.30
base $127.17 · payer covered $8,112.30
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2025-09-09
- Stop
- 2025-09-09
The parties
- Patient
- patient Elayne Raynor
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Medicaid
Record id
13979d01-bb1a-baed-4d35-9f95e744452a