Claim total
$949.77
base $127.17 · payer covered $759.82
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2017-04-28
- Stop
- 2017-04-28
The parties
- Patient
- patient Hans Marion Kuvalis
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicare
Record id
107d0674-dc76-cfa0-dd45-e69d24f46649