Claim total
$949.77
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2019-05-26
- Stop
- 2019-05-26
The parties
- Patient
- patient Kirk Merle Hickle
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Cigna Health
Record id
131edf5b-4fb3-6f88-039e-d70da6b8ccaf