Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2020-04-17
- Stop
- 2020-04-18
The parties
- Patient
- patient Rosario Lucia Avilés
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Aetna
Record id
199a763e-853b-2729-3ae1-e5c5a6a6969e