Claim total
$538.47
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of knee125601008
- Start
- 2019-02-26
- Stop
- 2019-02-26
The parties
- Patient
- patient Allene Jonell Stark
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer UnitedHealthcare
Record id
39bdbcaa-0f4c-539e-1a4f-5cc321c2d71e