Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Injury of neck90460009
- Start
- 2021-05-31
- Stop
- 2021-05-31
The parties
- Patient
- patient Courtney Clifton Roberts
- Provider
- provider Valeria Hoeger
- Care site
- care site PROVIDENCE PLACE
- Payer
- payer Medicaid
Record id
15a85dbf-71f7-c524-fe95-0611e009e47d