Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2022-12-31
- Stop
- 2023-01-16
The parties
- Patient
- patient Dorsey Kuhic
- Provider
- provider Raymond Ebert
- Care site
- care site CARONDELET VILLAGE CARE CENTER
- Payer
- payer Aetna
Record id
3ac60cc0-6d0a-3f39-d00e-2ed119cd2482