Claim total
$127.17
base $127.17 · payer covered $76.30
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2021-07-07
- Stop
- 2021-07-07
The parties
- Patient
- patient Beverley Kattie Keebler
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Aetna
Record id
0cb24d24-cb62-5e83-bd2a-bbfe24e3be29