Claim total
$14,218.59
base $127.17 · payer covered $11,374.87
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2019-11-12
- Stop
- 2019-11-13
The parties
- Patient
- patient Talitha Gleason
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicare
Record id
23c94034-f050-04d5-1ef5-b28e27228da9