Claim total
$93.39
base $93.39 · payer covered $93.39
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Concussion injury of brain110030002
- Start
- 2024-03-28
- Stop
- 2024-03-28
The parties
- Patient
- patient Jared Lenard Hansen
- Provider
- provider Cornelia Altenwerth
- Care site
- care site MERCY HOSPITAL
- Payer
- payer Aetna
Record id
047ee4ec-c50b-b504-665c-1b72b15863be