Claim total
$665.03
base $127.17 · payer covered $532.02
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- —
- Start
- 2026-06-03
- Stop
- 2026-06-03
The parties
- Patient
- patient Lorilee Rau
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicare
Record id
01b2da20-8b0d-5eee-1507-3d92fc181512