Claim total
$4,992.38
base $127.17 · payer covered $3,993.90
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 1991-07-26
- Stop
- 1991-07-26
The parties
- Patient
- patient Maybelle Pansy Buckridge
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicare
Record id
2db4e680-0037-4778-3d78-d99696a8eb88