Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2026-02-10
- Stop
- 2026-02-10
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-d1ad-64905998fcae