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Visit

Emergency room admission

One dated clinical visit by one patient.

Neighborhood Provenance
Claim total
$1,361.07
base $127.17 · payer covered $1,326.07

The visit

Class
Emergency
Code
50849002
Reason
diagnosis concept Traumatic dislocation of temporomandibular joint81629009
Start
2023-01-29
Stop
2023-01-29

The parties

Patient
patient Sharie Nikia Hegmann
Provider
provider Emerson Jast
Care site
care site SOUTHSIDE COMMUNITY CLINIC
Payer
payer Dual Eligible
Record id 00decd7e-554a-447f-724e-d76bd19f46d9