Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Concussion injury of brain110030002
- Start
- 2008-01-13
- Stop
- 2008-01-13
The parties
- Patient
- patient Zachery Palmer Walter
- Provider
- provider Sheree Kreiger
- Care site
- care site MARANATHA CARE CENTER
- Payer
- payer Humana
Record id
08dc4a70-d264-2427-bdb4-7dda6ae423f9