Claim total
$10,957.25
base $127.17 · payer covered $10,907.25
The visit
- Class
- Emergency
- Code
- 183460006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-06-11
- Stop
- 2025-06-11
The parties
- Patient
- patient Amanda Rheba Mitchell
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicaid
Record id
0363ed75-83f4-7675-c2b5-090702d131cc