Claim total
$9,827.37
base $127.17 · payer covered $9,777.37
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Seizure disorder128613002
- Start
- 2009-06-11
- Stop
- 2009-06-11
The parties
- Patient
- patient Royce Peter Wolf
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicaid
Record id
04658673-6112-6940-ca86-04b8a89f6155