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
- 2023-12-27
- Stop
- 2023-12-27
The parties
- Patient
- patient Dean Larhonda Hickle
- Provider
- provider Marquerite Swaniawski
- Payer
- payer No insurance
Record id
0d9b1928-215c-a673-d1b2-9da19ebd047f