Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Burn injury48333001
- Start
- 2023-07-30
- Stop
- 2023-07-30
The parties
- Patient
- patient Randell Pfeffer
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicare
Record id
3642746e-ee7c-d37f-1513-af4727c0c9bf