Claim total
$127.17
base $127.17 · payer covered $89.02
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2025-08-28
- Stop
- 2025-08-28
The parties
- Patient
- patient Oliver Ricky Schuster
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
Record id
14c54cab-0cb9-431a-1790-a8f1619826ee