Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2017-09-13
- Stop
- 2017-09-13
The parties
- Patient
- patient Renda Sonya MacGyver
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Medicaid
Record id
3502b5eb-e4fe-8ea0-9165-4fe9c10b7818