Claim total
$538.47
base $127.17 · payer covered $430.78
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of knee125601008
- Start
- 1969-10-13
- Stop
- 1969-10-13
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-ef1c-096415707946