Claim total
$127.17
base $127.17 · payer covered $127.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2019-10-03
- Stop
- 2019-10-03
The parties
- Patient
- patient Lindsay Charlie Hilll
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
Record id
1ae11b6f-7c0b-81fc-6770-55748436ab4f