Claim total
$3,668.70
base $127.17 · payer covered $2,934.96
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2019-08-31
- Stop
- 2019-09-01
The parties
- Patient
- patient Clarence Oberbrunner
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicare
Record id
3ae407fa-7b32-4ba2-9c96-f5dfacf44962