Claim total
$3,935.75
base $127.17 · payer covered $3,095.64
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2025-04-20
- Stop
- 2025-04-20
The parties
- Patient
- patient Brent Collins
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicare
Record id
2e1faf61-63f6-ea99-2f0e-691b17a8f2e5