Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2009-11-02
- Stop
- 2009-11-02
The parties
- Patient
- patient Kent Ethan Yundt
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer No insurance
Record id
27b3914f-dfc0-a4bc-7f0d-bb30a30ca33f