Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2020-11-20
- Stop
- 2020-11-20
The parties
- Patient
- patient Darrin Sterling Stroman
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer UnitedHealthcare
Record id
136a97db-05da-4b74-b9d0-6f7ab21abf66