Claim total
$14,063.88
base $127.17 · payer covered $11,142.79
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2018-01-13
- Stop
- 2018-01-13
The parties
- Patient
- patient Linh Sindy Heaney
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicare
Record id
013d575b-4a77-458a-27a5-3fabdda15aef