Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2013-10-08
- Stop
- 2013-10-08
The parties
- Patient
- patient Cyndy Thora Hackett
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicare
Record id
3a6342ed-106b-b99c-e528-de2cf8249185