Claim total
$127.87
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- —
- Start
- 2026-03-24
- Stop
- 2026-03-24
The parties
- Patient
- patient Cleo Timothy Kemmer
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicaid
Record id
04d0e486-8d5f-7bad-75b7-49a9268c1fc1