Claim total
$3,935.75
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2017-02-04
- Stop
- 2017-02-04
The parties
- Patient
- patient Chana Jung Kuhlman
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Aetna
Record id
0b9ae72a-4873-5d31-e2db-dfdcc5b9cb34