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
- 2016-11-22
- Stop
- 2016-11-22
The parties
- Patient
- patient Peter Reichert
- Provider
- provider Emerson Jast
- Care site
- care site SOUTHSIDE COMMUNITY CLINIC
Record id
179faead-d106-032a-bdd0-94e5b7c5774d