Claim total
$3,935.75
base $127.17 · payer covered $3,885.75
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2017-12-25
- Stop
- 2017-12-25
The parties
- Patient
- patient Karl Mickey O'Reilly
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Medicaid
Record id
16f58d27-cd9e-7f53-6404-720541b7ac0b