Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 1992-01-22
- Stop
- 1992-01-23
The parties
- Patient
- patient Raven Julieta Johnson
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer No insurance
Record id
1c0fdca8-d5a1-2af7-abcf-906c986011e2