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
- 2019-04-02
- Stop
- 2019-04-02
The parties
- Patient
- patient Humberto Erich Powlowski
- Provider
- provider Marquerite Swaniawski
- Payer
- payer UnitedHealthcare
Record id
0aad30a9-ee82-876e-cde5-d7fcc820f3c0