Claim total
$16,418.17
base $127.17 · payer covered $16,368.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2025-12-09
- Stop
- 2025-12-09
The parties
- Patient
- patient Karma Jenee West
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Medicaid
Record id
1ab7fdc1-9dad-8bb2-47d4-50af43b61022