Claim total
$15,361.54
base $127.17 · payer covered $12,289.24
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2012-01-23
- Stop
- 2012-01-23
The parties
- Patient
- patient Kallie Lynna Hagenes
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicare
Record id
0a242b14-0437-1a7e-d5a3-805f8a01ff05