Claim total
$538.47
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of knee125601008
- Start
- 2020-12-10
- Stop
- 2020-12-10
The parties
- Patient
- patient Duncan Nolan Schuppe
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Aetna
Record id
11c30a63-d3ba-081c-b425-61219adee04b