Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Concussion injury of brain110030002
- Start
- 2020-11-30
- Stop
- 2020-11-30
The parties
- Patient
- patient Lindsay Charlie Hilll
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
Record id
1ae11b6f-7c0b-81fc-eb13-a3f2450cb85a