Claim total
$3,557.06
base $127.17 · payer covered $3,522.06
The visit
- Class
- Emergency
- Code
- 183460006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2019-12-02
- Stop
- 2019-12-02
The parties
- Patient
- patient Rosaria Golden Bashirian
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Dual Eligible
Record id
015dd051-d88b-0f3d-7328-68fc7d020fcd