Claim total
$11,573.86
base $127.17 · payer covered $9,259.09
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2017-08-02
- Stop
- 2017-08-03
The parties
- Patient
- patient Clarence Oberbrunner
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Medicare
Record id
3ae407fa-7b32-4ba2-a91a-070f92ed0d1e