Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2019-01-18
- Stop
- 2019-01-18
The parties
- Patient
- patient Mikki Barbra Windler
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Humana
Record id
1cfadccd-2786-e3f9-4b1e-a78557e4e15c