Claim total
$5,545.60
base $127.17 · payer covered $5,395.60
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2019-10-16
- Stop
- 2019-10-16
The parties
- Patient
- patient Hassie Merlyn Hayes
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Medicaid
Record id
39926a5e-6994-6990-96d7-b1ab47f8b9f4