Claim total
$538.47
base $127.17 · payer covered $430.78
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of knee125601008
- Start
- 2016-06-01
- Stop
- 2016-06-01
The parties
- Patient
- patient Delphia Ilse Altenwerth
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicare
Record id
1442b902-3b39-ca20-51c9-2a8c082b85d2