Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2021-08-03
- Stop
- 2021-08-03
The parties
- Patient
- patient Daren Lino Reinger
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Humana
Record id
22a9563f-1a38-933c-073c-f1da494ae857