Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2023-05-11
- Stop
- 2023-05-11
The parties
- Patient
- patient Natacha Chi Blick
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer No insurance
Record id
3482eb70-2081-c8cb-5aa2-53c1e0e34ced