Claim total
$949.77
base $127.17 · payer covered $664.84
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2026-02-20
- Stop
- 2026-02-20
The parties
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
Record id
1bbb5437-0079-7cbc-2f96-87f25f700cbe