Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2021-03-08
- Stop
- 2021-03-08
The parties
- Patient
- patient Adriana Ramona Muro
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer UnitedHealthcare
Record id
2c023a36-c0d5-53e8-064b-df05f7462b17