Claim total
$7,233.93
base $127.17 · payer covered $7,198.93
The visit
- Class
- Emergency
- Code
- 183460006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2020-07-11
- Stop
- 2020-07-11
The parties
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Dual Eligible
Record id
021142be-3a32-af72-8673-6d28da7a43dd