Claim total
$16,418.17
base $127.17 · payer covered $12,124.30
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2018-06-16
- Stop
- 2018-06-16
The parties
- Patient
- patient Antony Darrel Hand
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Anthem
Record id
1bf6aaa3-13d1-d98a-9a60-3e39303eb35b