Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2024-02-15
- Stop
- 2024-02-15
The parties
- Patient
- patient Margo Jene Beier
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer UnitedHealthcare
Record id
2acc43d9-4ea6-321e-b8e0-a2ff7602d1df