Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Concussion with no loss of consciousness62106007
- Start
- 2025-09-16
- Stop
- 2025-09-16
The parties
- Patient
- patient Dorotea Yolanda Palomo
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
04ad2732-b952-4fbb-34e9-dc821d2bf72a