Claim total
$5,795.46
base $127.17 · payer covered $3,477.27
The visit
- Class
- Emergency
- Code
- 183460006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-10-18
- Stop
- 2025-10-19
The parties
- Patient
- patient Corrina Leontine Smith
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Humana
Record id
03b48c3f-9d97-2f75-ed2a-7184569b7bd5