Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 1996-12-07
- Stop
- 1996-12-07
The parties
- Patient
- patient Jacqulyn Lavonna Legros
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Humana
Record id
28e07049-ca1f-fcfe-f75f-52f344a2d17f