Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2024-12-10
- Stop
- 2024-12-10
The parties
- Patient
- patient Arthur Virgilio Friesen
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Cigna Health
Record id
14033b02-afc1-a19c-9140-e3a64b3df083