Claim total
$538.47
base $127.17 · payer covered $17.34
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of knee125601008
- Start
- 2021-10-22
- Stop
- 2021-10-22
The parties
- Patient
- patient Stevie Paris Bechtelar
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Anthem
Record id
18202402-df4f-60f9-83e6-f727b4702699