Claim total
$949.77
base $127.17 · payer covered $899.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2024-09-13
- Stop
- 2024-09-13
The parties
- Patient
- patient Elton Terry
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Medicaid
Record id
2e535c28-ca75-923c-bf44-f7dd0e9698f3