Claim total
$15,361.54
base $127.17 · payer covered $15,311.54
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2008-06-11
- Stop
- 2008-06-11
The parties
- Patient
- patient Solomon Amado Purdy
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Medicaid
Record id
1e6fa6a9-1f41-5355-3054-f901fee807a9