Claim total
$4,151.34
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2020-01-21
- Stop
- 2020-01-21
The parties
- Patient
- patient Bernie Wallace Collier
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Cigna Health
Record id
29412692-9fd9-a01e-1761-8949d47d5247