Claim total
$949.77
base $127.17 · payer covered $759.82
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 1972-10-17
- Stop
- 1972-10-17
The parties
- Patient
- patient Elisha Duncan Hartmann
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicare
Record id
0e205e2d-543b-28ab-e722-c83963560326