Claim total
$76.30
base $76.30 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 183452005
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2017-04-07
- Stop
- 2017-04-07
The parties
- Patient
- patient Terrance Raymon Kuhic
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicaid
Record id
03e733d5-721a-3740-5926-c739b3e932fd