Claim total
$127.17
base $127.17 · payer covered $76.30
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2021-08-29
- Stop
- 2021-08-29
The parties
- Patient
- patient Misty Celestine Kuhn
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Humana
Record id
356a05d5-08f1-799a-0e05-66d7452a0c6b