Claim total
$13,332.34
base $127.17 · payer covered $10,665.88
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2025-07-19
- Stop
- 2025-07-20
The parties
- Patient
- patient Regine Hayley Hirthe
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicare
Record id
38ba432b-b122-8312-5fcb-57441a5a5492