Claim total
$4,342.56
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2019-07-23
- Stop
- 2019-07-23
The parties
- Patient
- patient Wei Leoma Bartoletti
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Aetna
Record id
244d6b00-ebfa-1c46-bb4b-55eea216e59a