Claim total
$9,703.45
base $127.17 · payer covered $7,654.44
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Fracture of bone125605004
- Start
- 2026-06-02
- Stop
- 2026-06-02
The parties
- Patient
- patient Howard Gregory Koch
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicare
Record id
2ec30b36-a246-6bf9-2028-9c3762b78274