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
- 2019-01-27
- Stop
- 2019-01-27
The parties
- Patient
- patient Shery Witting
- Provider
- provider Juli Predovic
- Care site
- care site KINDRED AT HOME
- Payer
- payer Humana
Record id
11fd5a97-02b2-f430-0b0e-63b704fc5f12