Claim total
$3,935.75
base $127.17 · payer covered $3,148.60
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2022-12-17
- Stop
- 2022-12-17
The parties
- Patient
- patient Hanh Tyisha Purdy
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Medicare
Record id
2f6994a4-a6fb-f981-9986-55a7b68d805f