Claim total
$16,569.23
base $127.17 · payer covered $13,255.39
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2025-04-20
- Stop
- 2025-04-21
The parties
- Patient
- patient Bettina Kira Schiller
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicare
Record id
0d6a874a-279a-257b-5713-6c7a53e2afd8