Claim total
$7,194.94
base $127.17 · payer covered $5,571.11
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- —
- Start
- 2022-10-25
- Stop
- 2022-10-25
The parties
- Patient
- patient Kenny Goldner
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicare
Record id
12ea5fbe-2a75-7aca-7807-58d35b6a1409