Claim total
$538.47
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of knee125601008
- Start
- 2020-01-16
- Stop
- 2020-01-16
The parties
- Patient
- patient Josue Zieme
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Humana
Record id
15d47cb0-fee9-7cea-3b7f-9571fa880ef8