Claim total
$4,252.58
base $76.30 · payer covered $4,202.58
The visit
- Class
- Emergency
- Code
- 185345009
- Reason
- diagnosis concept Acute infective cystitis307426000
- Start
- 2025-04-17
- Stop
- 2025-04-17
The parties
- Patient
- patient Carmel Candace Corwin
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicaid
Record id
05f2be84-5448-13b2-a5ad-bbb71ce09bc3