Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2022-08-30
- Stop
- 2022-08-30
The parties
- Patient
- patient Antony Darrel Hand
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Aetna
Record id
1bf6aaa3-13d1-d98a-5c3d-ecea5981f55e