Claim total
$14,523.50
base $127.17 · payer covered $14,473.50
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2021-02-04
- Stop
- 2021-02-04
The parties
- Patient
- patient Isaiah Lesch
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicaid
Record id
30fd7e10-dfb5-c4bb-339e-3c039fe61260