Claim total
$3,834.43
base $127.17 · payer covered $3,784.43
The visit
- Class
- Emergency
- Code
- 183460006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2020-08-14
- Stop
- 2020-08-14
The parties
- Patient
- patient Carolynn Gabriele Zemlak
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicaid
Record id
032e4024-8595-f612-3769-68099a3b98a4