Claim total
$127.17
base $127.17 · payer covered $127.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Concussion injury of brain110030002
- Start
- 2023-08-02
- Stop
- 2023-08-02
The parties
- Patient
- patient Carrie Torphy
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Cigna Health
Record id
18bc0be0-d304-d0f5-9a5f-0fcddae2b4c8