Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 1985-08-04
- Stop
- 1985-08-05
The parties
- Patient
- patient Stefany Etha Heaney
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer No insurance
Record id
2e1cff54-5d49-d229-f415-5044093ba72e