Claim total
$15,361.54
base $127.17 · payer covered $11,980.39
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2016-11-18
- Stop
- 2016-11-18
The parties
- Patient
- patient Kiara Arlinda Kling
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer UnitedHealthcare
Record id
2ffd8dcb-d798-da16-6b9e-4195deec0470