Claim total
$76.30
base $76.30 · payer covered $26.30
The visit
- Class
- Emergency
- Code
- 183452005
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2017-08-13
- Stop
- 2017-08-13
The parties
- Patient
- patient Lee Scot Rosenbaum
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicaid
Record id
027e2621-860b-6019-abcb-1d26ab0ac7e5