Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2016-12-09
- Stop
- 2016-12-09
The parties
- Patient
- patient Len Hunter Schneider
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicare
Record id
31182b1e-4f85-2b24-5449-758506b1a96f