Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2019-07-12
- Stop
- 2019-07-12
The parties
- Patient
- patient Stevie Paris Bechtelar
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Anthem
Record id
18202402-df4f-60f9-d966-6f726f90e764