Claim total
$5,365.58
base $127.17 · payer covered $96.84
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2022-06-09
- Stop
- 2022-06-09
The parties
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Humana
Record id
1b3a73cf-f85d-0e27-10c5-69203c1df9f6