Claim total
$10,319.48
base $127.17 · payer covered $3,541.77
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Laceration - injury312608009
- Start
- 2024-05-22
- Stop
- 2024-05-22
The parties
- Patient
- patient Julee Corwin
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
- Payer
- payer Aetna
Record id
3b09745b-0b4e-2893-b002-3e2594a46d99