Claim total
$4,862.82
base $127.17 · payer covered $2,513.92
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2022-04-19
- Stop
- 2022-04-19
The parties
- Patient
- patient Roscoe Garrett Towne
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Aetna
Record id
19f34a84-17cb-b239-e7a9-a4a1db6805ec