Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2005-11-09
- Stop
- 2005-11-09
The parties
- Patient
- patient Venita O'Kon
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Medicare
Record id
154d46ed-86f8-1fbe-ebb1-82604c8a2ad7