Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Sprain384709000
- Start
- 2023-05-02
- Stop
- 2023-05-02
The parties
- Patient
- patient Victor Denis Cole
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Cigna Health
Record id
1fe76002-6b9a-6bae-a749-e354d1fb6b67